Emotional experiences and gender roles of men with fibromyalgia syndrome: a cross-cultural qualitative study.

Introduction: Gender roles may impact men with fibromyalgia, causing a high number of negative emotional states and affective disorders. There are few studies that detect men's high emotional suffering. This study examined the emotional experience of men with fibromyalgia. Methods: A qualitative cross-cultural study utilized inductive thematic analysis was performed at the Fibromyalgia and Chronic Fatigue Unit Santa Maria University Hospital in Spain, the Fibromyalgia and Chronic Fatigue Clinic at Mayo Clinic in the US, and volunteers from the Winneshiek County in the US A total of 17 participants, 10 men from Spain and 7 men from the US were included. Results: Three themes related to feelings/emotions emerged: (1) psychological level; (2) social level; and (3) physical level. Men with fibromyalgia from Spain and the US experienced many negative emotions. Men often experience negative emotions that are worsened by common misunderstandings and social biases/stigma about their condition. Conclusion/implications: A proper assessment of emotions when evaluating the global health of men with fibromyalgia as well as the provision of emotional support would improve their mental health and therefore their overall physical health. Emotional management should be incorporated into all treatment protocols for fibromyalgia, especially for men given the gender stigma. Health policies designed by legislators, policymakers, and support agencies must be accompanied by education in gender role concepts to improve the emotions of men with FMS. The mass media will be essential for the disclosure of the emotional suffering of male patients so that society might better understand them.

Physical Activity and Exercise Experience in Spanish and US Men with Fibromyalgia: A Qualitative Cross-Cultural Study.

Physical exercise is an indispensable element in the multidisciplinary treatment of fibromyalgia syndrome (FMS). The present study examined if men diagnosed with FMS engaged in any type of physical activity or exercise, the perceived effects from exercise, and who specifically recommended exercise. A qualitative cross-cultural study was performed in fibromyalgia clinical units in Spain and the United States. A total of 17 participants, 10 men from Spain and 7 men from the US, were included. In Spain, a focus group was completed in two parts, one month apart in 2018. In the US, five individual interviews and one joint interview with two men were completed in 2018. Three central themes appeared in the qualitative data: (1) Understanding what constitutes physical activity or exercise, (2) Facilitating or discouraging the performance of physical exercise, and (3) Effects of physical activity or exercise on psychological and social symptoms. The actual practice of exercise by patients with FMS is often perceived as leading to pain and fatigue, rather than a treatment facilitator. Physical activity and exercise can provide benefits, including relaxation, socialization, and increased muscle tone. However, minor opioids limit physical activity as they cause addiction, drowsiness, and decrease physical activity in Spanish men. Recommendations in a clinical setting should incorporate exercise as well as physical activity via daily life activities.

Fibromyalgia Syndrome Pain in Men and Women: A Scoping Review.

Fibromyalgia syndrome (FMS) is a chronic musculoskeletal disorder of unknown etiology that affects up to 5.0% of the world population. It has a high female predominance, between 80 and 96%. Due to the low number of diagnosed men, research work has focused mainly on women. The extensive body of literature on sex differences in pain in the general population suggests that men and women differ in their responses to pain, with greater sensitivity to pain and a higher risk of clinical pain commonly observed among women. This review aims to: (1) determine how pain is assessed or what types of questionnaires are used, (2) examine whether there are differences in pain characteristics between men and women with FMS and (3) describe how pain is conceptualized or manifested in patients at a qualitative level. In this study, the scoping review method of articles published in the last 5 years (2016-2022) was used. Ten articles were included. The most used questionnaires and scales to assess pain were the PVAS (Pain Visual Analogue Scale) and the FIQ (Fibromyalgia Impact Questionnaire). On the other hand, five categories were obtained: (1) qualities of pain, (2) uncertainty and chaos, (3) pain as an aggravating factor, (4) adaptation to the new reality and (5) the communication of pain. It has been observed that both subjective perception and widespread pain are higher in women. Men, on the other hand, have a worse impact of the pathology, more painful experiences and more catastrophic thoughts about pain. An updated knowledge of pain in FMS and whether it differs according to sex would be beneficial for clinicians to make an earlier diagnosis and treatment and, in turn, benefit patients suffering from this chronic disease.

The use of oxygen as a possible screening biomarker for the diagnosis of chronic fatigue

Background: The aim of this study was to verify whether the mean percentage of oxygen use in the aerobic-anaerobic transition phase or isocapnic buffering (IB) was lower in women with chronic fatigue syndrome (CFS) compared to healthy women, and if this variable could be used as a screening biomarker for the diagnosis of CFSMethodsA cross-sectional study was conducted. Forty-four adult women (22 with CFS and 22 healthy) performed a cycle ergometer stress test with gas analyser (CPET). Maximum oxygen consumption (V˙O2 max), oxygen consumption at the anaerobic threshold (V˙O2 at Vt2), maximum ventilatory volume (V˙E max), time of maintenance of the isocapnic buffering phase (IB duration), and mean percentage of oxygen use in isocapnic buffering phase (% O2 use in IB) were analyzed. Data were explored from a principal component analysis. Groups were matched by propensity score to be mismatched in BMI and a comparison of means and medians was performed. A logistic regression model was built to predict the probability of CFS.ResultsThe mean and median values of the variables obtained in the CPET was significantly higher in the healthy group compared to the CFS. In the logistic regression model, VO2 max, IB duration, and mean % of O2 use in IB were selected as predictors. The sensitivity and specificity were greater than 90%.ConclusionThe combination of the factors V˙O2 max, IB duration, and mean % of O2 use in IB can be used as a screening biomarker for the diagnosis of CFS. (AU)

Symptomatology of Fibromyalgia Syndrome in Men: A Mixed-Method Pilot Study.

Fibromyalgia syndrome (FMS) is characterized by generalized chronic musculoskeletal pain, fatigue, and sleep disturbance, as well as cognitive, somatic, and other symptoms. Most people affected by FMS are women, and studies analyzing this condition in men are scarce. In this study, we discuss the physical and psychological symptoms of FMS in men, analyze the possible side effects of pharmacological therapies, and explore the impact of the illness comparing these results between the different classification groups according to sociodemographic variables (marital status, level of education, employment situation and number of people living at home). We used a sequential exploratory mixed method (MM). Qualitative information was obtained from two focus groups (n = 10). Structured questionnaires were administered to 23 men affected by FMS. The mean age of the participants was 51.7 years (SD = 9.64). The most common drugs used were antidepressants and anxiolytics (86.9%), followed by non-steroidal anti-inflammatory drugs (82.6%) and opioids (60.9%). Current level of pain was high (8.2; SD = 1.1), while perceived health and satisfaction with pharmacological treatments were low (4.6; SD = 2.6 and 3.5; SD = 3.2, respectively). The impact of FMS measured using the Fibromyalgia Impact Questionnaire (FIQ) was very high at 88.7 (SD = 8.2). Six categories related with symptoms and side effects of the medication were observed in the qualitative data: (1) main physical symptoms, (2) mood disorders, (3) insomnia and non-restorative sleep, (4) cognitive disturbance, (5) hypersensitivity, and (6) symptoms secondary to opioids. Pain and fatigue were the symptoms most often mentioned by the participants (70% and 80%, respectively). Other important symptoms were anxiety, depression, and memory and sleep disorders. The consumption of opioids causes further unwanted symptoms such as drowsiness and dependence, which makes it difficult for patients to perform basic everyday activities. We believe it is vitally important to continue investigating this symptomatology in order to improve diagnosis and treatment for these patients.

Multidisciplinary rehabilitation treatments for patients with fibromyalgia: a systematic review.

INTRODUCTION: Fibromyalgia (FM) is a pathology that causes physical, psychological, and social problems. For this reason, it requires treatment that involves all of these elements. The main of study is to examine multidisciplinary rehabilitation treatment (MRT) in fibromyalgia and to identify healthcare approaches developing effective MRT tools for the treatment of FM. EVIDENCE ACQUISITION: In this systematic review, we searched the following databases: CINAHL, PubMed, Scopus, Cuidatge, Cuiden, ENFISPO, IBEC and IME. EVIDENCE SYNTHESIS: Of 356 articles found we selected 13 to analyze and summarize. We created 4 different categories: 1) multidisciplinary rehabilitation treatment focusing on health education and cognitive behavioral therapy (CBT); 2) multidisciplinary rehabilitation treatment that includes dietetics; 3) multidisciplinary rehabilitation treatment adapted to the patients' characteristics; 4) multidisciplinary rehabilitation treatment based on physical exercise. CONCLUSIONS: This review identifies the most effective treatments that may be usefully applied in many different rehabilitation contexts. These include all treatments that incorporated an education (ED) program to patients and an exercise program complete with aerobic exercise (AE), stretching (SE), relaxation (RE), strengthening (TE), endurance (EN), and which includes the entire body and biofeedback. Furthermore, many approaches also include cognitive behavioral therapy (CBT) for self-management such as occupational therapy, moderation, acceptance, commitment, motivation to change and forgiveness.

Fibromyalgia Pain and Fatigue Symptoms in Spanish and U.S. Men.

BACKGROUND AND AIMS: Fibromyalgia Syndrome (FMS) is a chronic centralized pain disorder characterized by widespread pain and fatigue. Of those affected by FMS, the majority are women, and minimal research exists involving men. The purpose of this paper is to describe the pain and fatigue experiences of men with FMS from two Western countries, Spain and the United States, in order to support more accurate and earlier recognition and diagnosis in men. DESIGN AND METHODS: We used individual and focus group interviews with qualitative and quantitative assessments. SETTINGS AND PARTICIPANTS/SUBJECTS: Ten men in Spain and seven men in the United States provided information about their symptoms, psychosocial and health-seeking behaviors, and gender experiences with FMS. RESULTS: Men articulated types, trends, and triggers of pain and fatigue that enrich an understanding of their symptoms. For example, men report more localized pain than generalized pain. Employment status and activities, among other contextual factors, impacted men's pain and fatigue experiences. CONCLUSIONS: Men experience distinct facets of pain and fatigue compared with women, with notable similarities and differences across the Spanish and U.S. SAMPLES: Cross-cultural comparisons highlight contextual factors that may inspire future inquiries about determinants of men's experiences with FMS. CLINICAL IMPLICATIONS: The present study could be useful for anyone treating men suffering from FMS, especially care providers in nursing, medical, and psychology fields. These initial findings may prompt a closer examination of recommendations for assessment and diagnostic criteria used internationally for patients with FMS with better recognition of men's experience.

Linfoma no Hodgkin y cervicalgia atípica. A propósito de un caso / Non-Hodgkin's lymphoma and atypical neck pain: a case report

La cervicalgia es un motivo de consulta muy frecuente en la consulta médica. Se sabe que al menos un 15% de la población activa y hasta el 40% de los profesionales de riesgo la presentan. Por otro lado, el linfoma óseo primario es una patología muy poco frecuente (menos del 1% de todos los tumores óseos malignos) y la asociación entre ambos ha sido pocas veces descrita. Presentamos el caso clínico de un paciente con clínica compatible con cervicalgia de un mes de evolución, que al examen físico destacaba dolor a la palpación de apófisis espinosas C2-C6 y contractura trapezoidal que no cedía con tratamiento habitual. Posterior a estudios de imagen patológicos, se interviene quirúrgicamente realizando exéresis de cuerpo vertebral C4 y masa tumoral epidural anterior más biopsia compatible con linfoma difuso de células grandes B. Buena evolución al tratamiento quirúrgico y radioterapia

Neck pain is a common reason for seeking medical attention. It affects at least 15% of the labor force and up to 40% of individuals whose occupation is hazardous. On the other hand, primary bone lymphoma is a very rare disease (less than 1% of all malignant bone tumors), and the relationship between the 2 has rarely been mentioned. We report the case of a patient who had a 1-month history of neck pain. The main symptom was pain on palpation of C2-C6 cervical spinous processes and contracture of the trapezius muscle that did not cease with conventional treatment. Imaging studies indicated an abnormality. He underwent surgery and the results of vertebral biopsy were compatible with diffuse large B-cell lymphoma. He was treated with radiotherapy with a good outcome

Non-Hodgkin's lymphoma and atypical neck pain: A case report. / Linfoma no Hodgkin y cervicalgia atípica. A propósito de un caso.

Neck pain is a common reason for seeking medical attention. It affects at least 15% of the labor force and up to 40% of individuals whose occupation is hazardous. On the other hand, primary bone lymphoma is a very rare disease (less than 1% of all malignant bone tumors), and the relationship between the 2 has rarely been mentioned. We report the case of a patient who had a 1-month history of neck pain. The main symptom was pain on palpation of C2-C6 cervical spinous processes and contracture of the trapezius muscle that did not cease with conventional treatment. Imaging studies indicated an abnormality. He underwent surgery and the results of vertebral biopsy were compatible with diffuse large B-cell lymphoma. He was treated with radiotherapy with a good outcome.

The effect of depressive symptoms on cognition in patients with fibromyalgia.

BACKGROUND: Fibromyalgia (FM) patients frequently complain of cognitive problems, but it remains unclear whether these cognitive complaints can be attributed to a dysfunction of the central nervous system or if they can be explained by other factors associated with the disease, such as depression, anxiety and sleep dysfunction. METHODS: One hundred and ten patients with FM were compared with thirty-three patients diagnosed with a depressive disorder (DD) and fifty healthy controls (HC). Several measures of attention and executive functions were used to make these comparisons and the patients were also asked to complete questionnaires on depression, anxiety and sleep quality. Univariate analyses of covariance (ANCOVA) were performed to identify and control confounders and multiple linear models were used to examine the effects of fibromyalgia and depression on cognitive measures. RESULTS: FM and HC differed significantly with respect to depression, anxiety and sleep dysfunction, whereas FM and DD did not differ in terms of symptoms of depression and anxiety. However, FM was associated with a worse quality of sleep than DD. Comparisons of cognitive performance between groups showed that short-term and working memory and inattention measures were only associated with symptoms of depression, whereas selective attention was associated with both depression and fibromyalgia, and processing speed, cognitive flexibility and inhibitory control showed a significant interaction between depression and fibromyalgia. Moreover, cognitive flexibility and inhibition abilities were specifically associated with FM. CONCLUSION: FM patients show a cluster of cognitive impairment in the attentional and executive domains, although some of the symptoms observed could be explained by the severity of the symptoms of depression, while others seem to depend on the effects of fibromyalgia. Implications of the findings for the understanding and management of cognitive impairment of FM patients are discussed.

Cognitive complaints in women with fibromyalgia: Are they due to depression or to objective cognitive dysfunction?

INTRODUCTION: Cognitive complaints are common in fibromyalgia, but it is unclear whether they represent an objective cognitive dysfunction or whether they could be explained by depressive symptoms. Here, we aim to elucidate the frequency of subjective cognitive complaints in a sample of women with fibromyalgia, in addition to analyzing associations between these subjective complaints and objective measures linked to the attention and executive cognitive domains. Finally, we aim to investigate the ability of demographic, clinical, and psychological variables to explain the subjective complaints observed. METHOD: One hundred and five women aged 30-55 years diagnosed with fibromyalgia completed a neuropsychological assessment, which included measures of attention and executive functions. They also completed self-report inventories of subjective cognitive complaints, depression, anxiety, intensity of pain, sleep quality, everyday physical functioning, and quality of life. RESULTS: Eighty-four percent of the patients reported subjective cognitive complaints. Depression scores, everyday physical functioning, and working memory performance were most strongly associated with subjective cognitive complaints. These three variables were significant predictors for subjective cognitive complaints with a final model explaining 32% of the variance. CONCLUSIONS: Cognitive complaints are very frequent in patients with fibromyalgia, and these are related to functional and cognitive impairment as well as to depressive symptoms.

Executive function in fibromyalgia: Comparing subjective and objective measures.

BACKGROUND: There is evidence to suggest the existence of an executive dysfunction in people diagnosed with fibromyalgia, although there are certain inconsistencies between studies. Here, we aim to compare executive performance between patients with fibromyalgia and a control group by using subjective and objective cognitive tests, analyzing the influence of patient mood on the results obtained, and studying associations between the two measures. METHOD: 82 patients diagnosed with fibromyalgia and 42 healthy controls, matched by age and years of education, were assessed using the Behavioral Rating Inventory of Executive Function - Adult Version (BRIEF-A) as a subjective measure of executive functioning. A selection of objective cognitive tests were also used to measure a series of executive functions and to identify symptoms of depression and anxiety. RESULTS: Patients with fibromyalgia perceived greater difficulties than the control group on all of the BRIEF-A scales. However, after adjustments were made for depression and anxiety the only differences that remained were those associated with the working memory scale and the Metacognition and Global Executive Composite index. In the case of the objective cognitive tests, a significantly worse overall performance was evidenced for the fibromyalgia patients. However, this also disappeared when adjustments were made for depression and anxiety. After this adjustment, fibromyalgia patients only performed significantly worse for the interference effect in the Stroop Test. Although there were no significant associations between most of the objective cognitive tests and the BRIEF-A scales, depression and anxiety exhibited strong associations with almost all of the BRIEF-A scales and with several of the objective cognitive tests. CONCLUSIONS: Patients with fibromyalgia showed executive dysfunction in subjective and objective measures, although most of this impairment was associated with mood disturbances. Exceptions to this general rule were observed in the impairment of working memory evidenced on the BRIEF-A scale and the inhibition impairment exhibited by the interference effect from the Stroop Test. The two types of measurement provide different yet complementary information.

Disfunción cognitiva en la fibromialgia / Cognitive dysfunction in fibromyalgia

Introducción. Las personas diagnosticadas de fibromialgia refieren de manera muy frecuente quejas sobre su pobre funcionamiento cognitivo. En los últimos años ha aumentado el interés para investigar cuáles son las alteraciones cognitivas presentes en esta enfermedad. Objetivo. Realizar una revisión de las investigaciones publicadas sobre fibromialgia y funciones cognitivas. Desarrollo. Se realizó una búsqueda bibliográfica con un intervalo temporal desde 1995 hasta 2012. Los términos de búsqueda incluyeron las palabras clave ‘fibromyalgia’ y ‘cognition’, ‘attention’, ‘memory’, ‘language’, ‘perception’, ‘executive functions’ y ‘disexecutive syndrome’. Se seleccionaron 64 registros tras aplicar criterios de inclusión. Conclusiones. Los estudios que han analizado las funciones cognitivas en las personas diagnosticadas de fibromialgia han sido escasos y mayoritariamente con muestras pequeñas. Se han identificado déficits principalmente en la memoria de trabajo y en las capacidades atencionales más complejas, donde el factor distracción tiene una relevancia importante. También se ha identificado deterioro en la memoria a largo plazo y en las funciones ejecutivas. Existe consenso entre los diversos estudios en que el grado de dolor tiene una relación directa con el nivel de disfunción cognitiva, mientras que no existe total consenso para explicar la influencia de la depresión y ansiedad sobre el funcionamiento cognitivo en estos pacientes (AU)

Introduction. People with a fibromyalgia diagnosis complain of having very poor cognitive functioning. In recent years, there has been an increasing interest to investigate which cognitive impairment is present in this disease. Aim. To review the published research on fibromyalgia and cognitive dysfunction. Development. A literature search was performed with a time interval from 1995 to 2012. Search terms included the keywords ‘fibromyalgia’ and ‘cognition’, ‘attention’, ‘memory’, ‘language’, ‘perception’, ‘executive functions’ and ‘disexecutive syndrome’. 64 records were selected after applying inclusion criteria. Conclusions. Studies that have examined cognitive function in people diagnosed with fibromyalgia have been few and mostly with small samples. Deficits have been identified mainly in working memory and complex attentional functions, where the distraction factor has an important significance. Impairment has also been identified in long-term memory and executive functions. There is consensus among the studies in which the degree of pain is directly related to the level of cognitive dysfunction, while no full consensus to explain the influence of depression and anxiety on cognitive functioning in these patients (AU)

[Cognitive dysfunction in fibromyalgia]. / Disfunción cognitiva en la fibromialgia.

INTRODUCTION: People with a fibromyalgia diagnosis complain of having very poor cognitive functioning. In recent years, there has been an increasing interest to investigate which cognitive impairment is present in this disease. AIM: To review the published research on fibromyalgia and cognitive dysfunction. DEVELOPMENT: A literature search was performed with a time interval from 1995 to 2012. Search terms included the keywords 'fibromyalgia' and 'cognition', 'attention', 'memory', 'language', 'perception', 'executive functions' and 'dis-executive syndrome'. 64 records were selected after applying inclusion criteria. CONCLUSIONS: Studies that have examined cognitive function in people diagnosed with fibromyalgia have been few and mostly with small samples. Deficits have been identified mainly in working memory and complex attentional functions, where the distraction factor has an important significance. Impairment has also been identified in long-term memory and executive functions. There is consensus among the studies in which the degree of pain is directly related to the level of cognitive dysfunction, while no full consensus to explain the influence of depression and anxiety on cognitive functioning in these patients.

TITLE: Disfuncion cognitiva en la fibromialgia.Introduccion. Las personas diagnosticadas de fibromialgia refieren de manera muy frecuente quejas sobre su pobre funcionamiento cognitivo. En los ultimos anos ha aumentado el interes para investigar cuales son las alteraciones cognitivas presentes en esta enfermedad. Objetivo. Realizar una revision de las investigaciones publicadas sobre fibromialgia y funciones cognitivas. Desarrollo. Se realizo una busqueda bibliografica con un intervalo temporal desde 1995 hasta 2012. Los terminos de busqueda incluyeron las palabras clave 'fibromyalgia' y 'cognition', 'attention', 'memory', 'language', 'perception', 'executive functions' y 'disexecutive syndrome'. Se seleccionaron 64 registros tras aplicar criterios de inclusion. Conclusiones. Los estudios que han analizado las funciones cognitivas en las personas diagnosticadas de fibromialgia han sido escasos y mayoritariamente con muestras pequenas. Se han identificado deficits principalmente en la memoria de trabajo y en las capacidades atencionales mas complejas, donde el factor distraccion tiene una relevancia importante. Tambien se ha identificado deterioro en la memoria a largo plazo y en las funciones ejecutivas. Existe consenso entre los diversos estudios en que el grado de dolor tiene una relacion directa con el nivel de disfuncion cognitiva, mientras que no existe total consenso para explicar la influencia de la depresion y ansiedad sobre el funcionamiento cognitivo en estos pacientes.

Osteonecrosis vertebral y vertebroplastia percutánea / Vertebral osteonecrosis and percutaneous vertebroplasty

La osteonecrosis vertebral se caracteriza por presentar el fenómeno de vacío intravertebral. Es un proceso poco frecuente y aunque puede ser debido a diferentes afecciones, la causa más frecuente es la postraumática. La explicación de que aparezca gas intravertebral no es del todo conocida. Presentamos el caso de una paciente de 74 años que después de sufrir un traumatismo vertebral inició clínica de dolor dorsolumbar intenso. El estudio radiológico simple, la tomografía computarizada y la resonancia magnética confirmaron el fenómeno del vacío intravertebral. Hemos hecho una revisión de este signo radiológico y comentamos la evolución después de vertebroplastia percutánea (AU)

Vertebral osteonecrosis is characterized by the presence of the intravertebral vacuum phenomenon. It is a relatively uncommon disease and although it may be caused by different pathologies, the most frequent cause is posttraumatic. The explanation for the presence of intravertebral gas is not known completely. We present the case of a 74-year-old patient who after suffering a vertebral traumatism, to complain of intense vertebral pain. A simple radiological study, CT scan, and magnetic resonance confirmed the presence of intravertebral vacuum phenomenon. We studied this radiological sign and then commented on its evolution after percutaneous vertebroplasty (AU)

[Vertebral osteonecrosis and percutaneous vertebroplasty]. / Osteonecrosis vertebral y vertebroplastia percutánea.

Vertebral osteonecrosis is characterized by the presence of the intravertebral vacuum phenomenon. It is a relatively uncommon disease and although it may be caused by different pathologies, the most frequent cause is posttraumatic. The explanation for the presence of intravertebral gas is not known completely. We present the case of a 74-year-old patient who after suffering a vertebral traumatism, to complain of intense vertebral pain. A simple radiological study, CT scan, and magnetic resonance confirmed the presence of intravertebral vacuum phenomenon. We studied this radiological sign and then commented on its evolution after percutaneous vertebroplasty.