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1.
Nutr. hosp ; 38(1): 139-145, ene.-feb. 2021. tab, graf
Artigo em Inglês | IBECS | ID: ibc-198850

RESUMO

INTRODUCTION: fibromyalgia (FM) is a chronic rheumatic disorder that is related to high levels of cholesterol, high values of diastolic pressure, higher waist-to-hip-ratio (WHR), and higher body mass index. OBJECTIVES: the aim of this study was to evaluate the effects of Ganoderma lucidum (GL) and Ceratonia siliqua (CS) on blood parameters and anthropometrical measures in women with fibromyalgia. METHODS: a double-blind randomized pilot trial was carried out. One group took 6 g/day of micro-milled carpophore powder of GL for 6 weeks, while the second group took the same dose of CS flour. Fasting glucose, cholesterol, triglycerides levels, weight, fat mass, muscular mass, waisthip ratio, and blood pressure were assessed. RESULTS: our results did not show any statistically significant differences in any of the outcome measures, even if there was a CS tendency to reduce fasting glucose levels and increase WHR. CONCLUSIONS: our results did not support the utility of both GL and CS as nutritional supplements to control blood parameters and anthropometric measures as assessed in women with fibromyalgia. Due to the limitations of the research, additional studies will be necessary to confirm our findings


INTRODUCCIÓN: la fibromialgia (FM) es una afección reumática crónica que está relacionada con altos niveles de colesterol, altos valores de presión diastólica, una mayor relación cintura-cadera y un mayor índice de masa corporal. OBJETIVOS: el objetivo de este estudio fue evaluar los efectos de Ganoderma lucidum (GL) y Ceratonia siliqua (CS) sobre los parámetros sanguíneos y antropométricos de mujeres con fibromialgia. MÉTODOS: se realizó un ensayo piloto aleatorizado con doble ciego. Un grupo tomó 6 g/día de carpóforos micromolidos de GL durante 6 semanas, mientras que el segundo grupo tomó la misma dosis de harina de CS. Se evaluaron los niveles de glucosa, colesterol y triglicéridos, el peso, la masa grasa, la masa muscular, la relación cintura-cadera y la presión arterial. RESULTADOS: los resultados no han evidenciado ninguna diferencia estadísticamente significativa entre el GL y la CS en ninguna de las medidas analizadas, aunque hubo tendencia de la CS a reducir los niveles de glucosa y aumentar la relación cintura-cadera. CONCLUSIONES: los resultados obtenidos indican que la suplementación de la dieta con GL y CS no tiene efectos positivos sobre los parámetros sanguíneos y antropométricos analizados en las mujeres con fibromialgia. Debido a las limitaciones del estudio, será necesario confirmar estos datos con ulteriores investigaciones


Assuntos
Humanos , Feminino , Reishi , Fabaceae , Glicemia , Metabolismo dos Lipídeos , Composição Corporal , Fibromialgia/diagnóstico , Fibromialgia/fisiopatologia , Colesterol , Relação Cintura-Quadril , Índice de Massa Corporal , Método Duplo-Cego , Pressão Arterial , Antropometria
2.
Clín. investig. ginecol. obstet. (Ed. impr.) ; 47(4): 164-167, oct.-dic. 2020.
Artigo em Espanhol | IBECS | ID: ibc-197645

RESUMO

El síndrome de sensibilidad química múltiple es un trastorno crónico poco conocido que ocasiona múltiples síntomas en diversos aparatos y sistemas del organismo tras la exposición a agentes químicos a muy bajas concentraciones consideradas no perjudiciales para la población. Se trata de un proceso de instauración solapada y progresiva que afecta de forma mayoritaria a mujeres de mediana edad. En 1987 Cullen propone el término de SQM, no siendo hasta 1999 cuando se llega a un consenso para su diagnóstico basado en los criterios de Nethercott, los cuales son publicados por Bartha. En España se reconoce la enfermedad en el año 2014 incluyéndose en el CIE-9-MC con el código 995, dentro del acápite de alergias no especificadas. Una actualización posterior en el año 2016 del CIE-10-MC la clasifica con el código T78.40. Su etiopatogenia a día de hoy es desconocida, por lo que la OMS no la ha reconocido como enfermedad, pero se cree que podrían participar factores genéticos, alergénicos, químicos y anatómicos. Se trata de una enfermedad neurológica, con factores de predisposición claros, que empeora al hacer sobreesfuerzos físicos o ante estresores psicológicos mínimos, así como por exposición a factores químicos y ambientales. Su diagnóstico es fundamentalmente clínico y a día de hoy no tiene un tratamiento específico. Exponemos el caso de una gestante afecta de esta patología, así como las medidas llevadas a cabo de forma multidisciplinar en el manejo del parto y puerperio inmediato


Multiple Chemical Sensitivity Syndrome is a poorly understood chronic disorder that causes multiple symptoms in various body systems and organs following exposure to chemicals at very low concentrations that are not considered to be harmful to the population. It is an overlapping and progressive process that mostly affects middle-aged women. In 1987 Cullen proposed the term MCS, but it was not until 1999 that a consensus was reached for its diagnosis based on Nethercott's criteria, which were published by Bartha. In Spain, the disease was recognized in 2014 and was included in the ICD-9-MC with the code 995, under the heading of Unspecified Allergies. A later update in 2016 of the ICD-10-MC classifies it as code T78.40. Its aetiopathogenesis is currently unknown, thus it has not been recognised by the WHO as a disease, but it is believed that genetic, allergenic, chemical, and anatomical factors may be involved. It is a neurological disease, with clear predisposing factors, which is made worse by physical overexertion or minimal psychological stress, as well as by exposure to chemical and environmental factors. Its diagnosis is fundamentally clinical, and it currently does not have a specific treatment. The case is presented of a pregnant woman affected by this disorder, who was cared for by a multidisciplinary team in the management of the childbirth and immediate puerperium


Assuntos
Humanos , Feminino , Gravidez , Adulto , Sensibilidade Química Múltipla/complicações , Sensibilidade Química Múltipla/diagnóstico , Equipe de Assistência ao Paciente , Complicações na Gravidez , Período Pós-Parto , Síndrome de Fadiga Crônica/diagnóstico , Fibromialgia/diagnóstico , Sensibilidade Química Múltipla/prevenção & controle
4.
Pain Physician ; 23(4): E353-E362, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32709181

RESUMO

BACKGROUND: Fibromyalgia (FM) syndrome is characterized by widespread pain, fatigue, and generalized increased pain sensitivity. Appropriate and simple pain models are methods employed to assess pain mechanisms that can potentially lead to improved treatments. Pressure pain thresholds (PPTs) or mapping the referred pain area produced by pressure stimulation at suprathreshold intensities are used to assess pain mechanisms. The optimal suprathreshold stimulation intensity to elicit referred pain with minimal discomfort for patients with FM has yet to be determined. OBJECTIVES: The aim of this study was to compare the area and intensity of pressure-induced referred pain in patients with FM as elicited by systematic increases in PPTs, compared with controls. STUDY DESIGN: Observational, crossed-section study. SETTING: Research laboratory. METHODS: Twenty-six patients with FM and 26 healthy controls, age- and gender-matched, were included. Suprathreshold stimulation was applied to the infraspinatus muscle of the dominant side at 4 different intensities (PPT +20%, +30%, +40%, and +50%), after which referred pain was evaluated by measuring the area of pain in pixels using a digital body chart and its intensity on a Visual Analog Scale. Factors related to anxiety condition, pain catastrophizing, depression, and quality of life were recorded. RESULTS: The referred pain areas were larger in the FM group compared with healthy individuals at 120% (P = 0.024), 130% (P = 0.001), 140% (P = 0.001), and 150% (P = 0.001) PPT, however, within the FM group no differences were found between the intensity of suprathreshold stimulation and the size of the referred pain areas (P = 0.135) or pain intensity (P > 0.05). There was a positive correlation between the size of referred pain areas and pain catastrophizing in the FM group (r = 0.457, P = 0.032). LIMITATIONS: This study presents some limitations, among which is the variability found in the referred pain areas. CONCLUSIONS: These findings show that referred pain induced by applying a suprathreshold pressure of 120% PPT can be a useful biomarker to assess sensitized pain mechanisms in patients suffering from FM. KEY WORDS: Referred pain, pain sensitivity, fibromyalgia, central sensitization, suprathreshold, pressure pain threshold, biomarker, facilitated pain mechanisms.


Assuntos
Fibromialgia/diagnóstico , Fibromialgia/psicologia , Medição da Dor/métodos , Limiar da Dor/psicologia , Dor Referida/diagnóstico , Dor Referida/psicologia , Adulto , Idoso , Catastrofização/diagnóstico , Catastrofização/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Limiar da Dor/fisiologia , Qualidade de Vida/psicologia , Adulto Jovem
5.
Inf. psiquiátr ; (240): 27-42, abr.-jun. 2020. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-194756

RESUMO

La fibromialgia afecta en gran medida a la calidad de vida de las personas que la sufren, así como a su funcionalidad, especialmente si la persona presenta síntomas comórbidos de ansiedad y/o depresión, lo que resalta la importancia del tratamiento psicológico. El objetivo del presente trabajo es comparar la eficacia de dos tratamientos cognitivo-conductuales breves en personas con diagnóstico de fibromialgia y con afectación emocional. Participaron un total de 44 personas (42 mujeres y 2 hombres) divididos en dos grupos de tratamiento: uno de ellos elaborado únicamente con componentes convencionales de la terapia cognitivo-conductual (grupo A) y el otro con los mismos componentes más un componente añadido de expresión emocional a través del dibujo (grupo B). Se encontraron puntuaciones significativamente mejores (p < 0,05) después de aplicar cualquiera de los dos tratamientos en las siguientes áreas: funcionalidad, percepción del dolor, ansiedad, depresión, catastrofismo, miedo al movimiento, estrategias de afrontamiento activo y percepción de autoeficacia. Se concluye que los resultados obtenidos apoyan la eficacia de ambos tratamientos cognitivo conductuales para personas con fibromialgia y afectación emocional


Fibromyalgia largely affects the life quality of people suffering from it, as well as its functionality, especially if the person has comorbid symptoms of anxiety and/or depression, which highlights the importance of psychological treatment. The objective of this study is to compare the efficacy of two brief cognitive-behavioral treatments in people with a fibromyalgia diagnosis and emotional involvement. A total of 44 people enrolled in the study (42 female, 2 male), divided within two treatment groups: one of them made only with conventional components of cognitive-behavioral therapy (group A) and the other with the same components plus an added component of emotional expression through drawing (group B). Significantly better scores were found (p < 0.05) after applying any of the two treatments in the following areas: functionality, pain perception, anxiety, depression, catastrophism, fear of movement, active coping strategies and self-efficacy perception. It is concluded that the results obtained support the efficacy of both cognitive-behavioral treatments for people with fibromyalgia and emotional involvement


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Idoso , Fibromialgia/psicologia , Terapia Cognitivo-Comportamental/métodos , Resultado do Tratamento , Qualidade de Vida/psicologia , Terapia Focada em Emoções/métodos , Ansiedade/psicologia , Depressão/psicologia , Fibromialgia/diagnóstico , Inquéritos e Questionários , Medição da Dor/métodos , Escalas de Graduação Psiquiátrica Breve , Terapia de Relaxamento , Adaptação Psicológica , Análise de Variância
6.
Postgrad Med ; 132(7): 575-580, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32314938

RESUMO

Health care has become increasingly fragmented, partly due to advancing medical technology. Patients are often managed by various specialty teams when presenting with symptoms that could be manifestations of different diseases. Approximately one third of them are referred to specialists, at over half for outpatient appointments. Fatigue, pain, depression, dry mouth, headaches, and arthralgia are common complaints and frequently require referral to specialist physicians. Differential diagnoses include fibromyalgia (FM), Sjogren's syndrome (SS), and depression. Evaluations involve various sub-specialist especially physicians like those practicing pain management, rheumatology, and psychiatry. Thresholds for referring vary. Patients sometime feel lost in a 'medical maze'. Disagreement is frequent between specialties regarding management. Each discipline has its own diagnostic and treatment protocols and there is little consensus about shared decision-making. Communication between doctors could improve continuity. There are many differences and similarities in the pathophysiology, symptomatology, diagnosis, and treatment of fibromyalgia, Sjogren's syndrome, and depression. Understanding the associations between fibromyalgia, Sjogren's syndrome and depression should improve clinical outcome via a common holistic approach.


Assuntos
Depressão/complicações , Fibromialgia/complicações , Síndrome de Sjogren/complicações , Depressão/diagnóstico , Diagnóstico Diferencial , Fadiga/complicações , Fibromialgia/classificação , Fibromialgia/diagnóstico , Humanos , Índice de Gravidade de Doença , Síndrome de Sjogren/classificação , Síndrome de Sjogren/diagnóstico
7.
Ann Intern Med ; 172(5): ITC33-ITC48, 2020 03 03.
Artigo em Inglês | MEDLINE | ID: mdl-32120395

RESUMO

Fibromyalgia is characterized by chronic, widespread musculoskeletal pain and associated fatigue, sleep disturbances, and other cognitive and somatic symptoms. For many patients, these symptoms persist for years and lead to frequent health care use; for some, fibromyalgia and its symptoms can be debilitating. Although many treatments are available, management remains challenging. This article highlights the clinical features of fibromyalgia, discusses diagnostic criteria and their evolution, and reviews treatment options.


Assuntos
Fibromialgia , Fibromialgia/diagnóstico , Fibromialgia/fisiopatologia , Fibromialgia/psicologia , Fibromialgia/terapia , Humanos , Educação de Pacientes como Assunto , Guias de Prática Clínica como Assunto , Prognóstico , Encaminhamento e Consulta , Fatores de Risco
8.
Clin Plast Surg ; 47(2): 203-213, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32115047

RESUMO

Fibromyalgia is characterized by generalized pain, specific sites of musculoskeletal tenderness, fatigue, sleep disturbance, headaches, and many other visceral and cognitive maladies. The epidemiology is not well-elucidated and the diagnoses and management can be difficult. Surgery may not be the most appropriate management of some of these pain conditions like fibromyalgia. It may even be more difficult to discern some surgical conditions from points of heightened sensitivity in the fibromyalgia patient. Close attention to the current and past medical history in such patients should aid the surgeon in his attempt to rid the patient of painful conditions through surgery.


Assuntos
Fibromialgia/diagnóstico , Manejo da Dor/métodos , Medição da Dor/métodos , Diagnóstico Diferencial , Fibromialgia/terapia , Humanos
9.
Clin Exp Rheumatol ; 38 Suppl 123(1): 3-8, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32116216

RESUMO

Fibromyalgia (FM) is a frequently encountered syndrome that is characterised by chronic widespread pain, fatigue, sleep disturbances, and many other symptoms that impair the quality of life. Its aetiopathogenesis is still unclear but, although there is no specific therapy, a number of pharmacological and non-pharmacological therapies are available. The aim of this review is to describe the most recent findings concerning the diagnosis, aetiopathogenesis and treatment of FM published between January 2019 and January 2020. They include the new concept of nociplastic pain, some neuroendocrine and metabolic alterations found in FM patients, and investigations concerning not only novel applications of old drugs, but also, and in particular, complementary therapies, such as the hyperbaric oxygen chamber, ozone therapy and mindfulness-based interventions.


Assuntos
Fibromialgia/diagnóstico , Fibromialgia/terapia , Dor Crônica , Terapias Complementares , Fadiga , Humanos , Qualidade de Vida
10.
Rev Esp Salud Publica ; 942020 Jan 10.
Artigo em Espanhol | MEDLINE | ID: mdl-31919340

RESUMO

OBJECTIVE: The clinical approach of fibromyalgia is a cause of frustration for some professionals due to the controversy on its diagnosis, etiopathology and clinical management. The aim of this study was to explore the beliefs and knowledge on fibromyalgia among health professionals from different specialties of the public health service from Almería province. METHODS: A descriptive and cross-sectional study was carried out. A questionnaire prepared ex profeso was applied to a sample of 103 clinicians from Primary Care Physicians, Mental Health, Internal Medicine and Rheumatology. The chi-square test was performed to explore the relationships among variables. RESULTS: 59.7% of Primary Care providers and 66.7% of Internal Medicine conceptualized fibromyalgia as a somatization. Likewise, 58.9% of Primary Care indicated that fibromyalgia should be considered in no case as a disabling illness, compared to 16.7% from Rheumatology, as well as for 42.5% of them the fibromyalgia diagnosis is not essential, compared to the amount of other specialties. Mood disorders were mentioned by 53.4% of Primary Care as entities from which fibromyalgia is difficult to discriminate. Sleep or gastrointestinal problems were mentioned by 83.3% and 50% of Rheumatology professionals, respectively. CONCLUSIONS: A high percentage of professionals considered fibromyalgia as a psychogenic entity, especially among Internal Medicine and Primary Care, highlighting in the last one a position against the consideration of disability and its difficult differentiation from mood disorders. These latest findings could be explained by beliefs or attitudes on the amplification of pain behaviors and secondary gains. A deeper knowledge on fibromyalgia symptoms from Rheumatology is highlighted. Methodological limitations and recommendations are discussed.


Assuntos
Atitude do Pessoal de Saúde , Consenso , Dissidências e Disputas , Fibromialgia , Adulto , Estudos Transversais , Feminino , Fibromialgia/diagnóstico , Fibromialgia/etiologia , Fibromialgia/psicologia , Fibromialgia/terapia , Humanos , Medicina Interna , Masculino , Pessoa de Meia-Idade , Atenção Primária à Saúde , Reumatologia , Espanha , Inquéritos e Questionários
11.
Pain Pract ; 20(2): 188-196, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31605651

RESUMO

OBJECTIVES: Recent studies support the opinion that central sensitization (CS) plays an important role in the pathophysiology of many chronic pain conditions. CS refers to hyperexcitability of the central nervous system, which can result in pain hypersensitivity and other somatosensory symptoms. Recognition of CS-related symptomology is crucial in chronic pain evaluation and rehabilitation. The Central Sensitization Inventory (CSI) was created to evaluate symptoms that have been found to be associated with CS. The aim of the current study was the cross-cultural adaptation of the CSI into Greek (CSI-Gr). METHODS: To evaluate discriminate validity, 200 patients with chronic pain and 50 healthy control subjects participated. The sample was divided into 4 diagnostic groups (fibromyalgia, single pain complaints, multiple pain complaints, and a control group) and into 5 CSI severity subgroups, from subclinical to extreme. Convergent validity was determined by evaluation of the relationship between the CSI-Gr and the Pain Catastrophizing Scale (PCS). Additionally, 30 patients completed the CSI a second time for the purpose of a test/retest analysis. RESULTS: The results showed high internal consistency (Cronbach's alpha = 0.994) and test-retest reliability (intraclass correlation coefficient = 0.993). The standard error of measurement was 2.1. The CSI-Gr correlated moderately with the PCS (r = 0.68). Statistically significant differences were found among the 3 comparison groups, with patients who had fibromyalgia reporting the highest CSI severity and healthy control subjects reporting the lowest severity. CONCLUSIONS: As determined in the present study, the CSI-Gr was found to be a reliable and valid tool for recognition of CS-related symptomology.


Assuntos
Dor Crônica/diagnóstico , Dor Crônica/etnologia , Comparação Transcultural , Medição da Dor/normas , Psicometria/normas , Adulto , Sensibilização do Sistema Nervoso Central/fisiologia , Feminino , Fibromialgia/diagnóstico , Fibromialgia/etnologia , Grécia/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Medição da Dor/métodos , Projetos Piloto , Psicometria/métodos , Distribuição Aleatória , Reprodutibilidade dos Testes , Inquéritos e Questionários/normas , Adulto Jovem
12.
Pain Pract ; 20(3): 269-276, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-31638741

RESUMO

OBJECTIVES: This study aimed to determine the optimal cutoff score of the 9-item short version of the CSI, the CSI-9, by comparing patients with central sensitivity syndrome (CSS) not only to healthy volunteers as with the original version, but also to patients with musculoskeletal (MSK) disorders. METHODS: All participants filled out the CSI, EuroQol 5-dimension, Brief Pain Inventory, and Pain Catastrophizing Scale questionnaires. To identify a clinically relevant cutoff score, receiver operating characteristic analyses were conducted. The area under the curve was used to examine the ability of the CSI-9 to distinguish patients with fibromyalgia (FM) from patients with MSK disorders and healthy individuals. RESULTS: Twenty-six participants with FM, 30 patients with MSK disorders, and 28 healthy individuals were included. We determined 2 cutoff scores: 20 for distinguishing patients with FM from patients with MSK disorders and 17 for distinguishing patients with FM from healthy individuals. These cutoff scores had good sensitivity (patients with MSK disorders, 92.3%; healthy individuals, 96.2%) and specificity (patients with MSK disorders, 93.3%; healthy individuals, 100%). In addition, the patients who scored above the cutoff of 20 points exhibited worse clinical symptoms (higher pain intensity, higher pain interference, higher Pain Catastrophizing Scale scores, and lower EuroQol 5-dimension scores) than those who scored below it. Furthermore, a significantly higher number of subjects who scored more than 20 on the CSI-9 had a history of 2 or more diagnoses of CSS. CONCLUSION: The optimal CSI-9 cutoff score of 20 is beneficial to clinicians in the evaluation of central sensitization-related symptoms. The cutoff score helps to identify patients who need additional treatments, such as pain neuroscience education and cognitive behavioral therapy.


Assuntos
Sensibilização do Sistema Nervoso Central , Fibromialgia/diagnóstico , Doenças Musculoesqueléticas/diagnóstico , Inquéritos e Questionários , Adulto , Dor Crônica/diagnóstico , Dor Crônica/etiologia , Feminino , Fibromialgia/complicações , Humanos , Masculino , Pessoa de Meia-Idade , Doenças Musculoesqueléticas/complicações , Curva ROC , Valores de Referência , Sensibilidade e Especificidade
14.
Rheumatology (Oxford) ; 59(3): 594-602, 2020 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-31411333

RESUMO

OBJECTIVES: Many patients with osteoarthritis have comorbid symptoms of FM, but it is unknown how these symptoms respond to surgical procedures that address nociceptive input in the periphery, such as total joint replacement. Here we explore differences in clinical characteristics between patients whose FM symptoms do and do not improve following total hip or knee replacement. METHODS: Participants were 150 patients undergoing knee or hip replacement who had a minimum FM survey score of 4 or greater prior to surgery. The top tertile of patients experiencing the most improvement in FM symptoms at month 6 were categorized as 'Improve' (n = 48) while the bottom two tertiles were categorized as 'Worsen/Same' (n = 102). Baseline symptom characteristics were compared between groups, as well as improvement in overall pain severity, surgical pain severity and physical function at 6 months. RESULTS: The Worsen/Same group had higher levels of fatigue, depression and surgical site pain at baseline (all P < 0.05). Additionally, they improved less on overall pain severity and physical functioning 6 months after surgery (both P < 0.05). CONCLUSION: Most patients derive significant benefit in improvement of comorbid FM symptoms following total joint replacement, but a substantial proportion do not. Understanding the neurobiological basis for these different trajectories may help inform clinical judgment and improve patient care.


Assuntos
Artroplastia de Quadril , Artroplastia do Joelho , Fibromialgia/diagnóstico , Osteoartrite do Quadril/cirurgia , Osteoartrite do Joelho/cirurgia , Idoso , Feminino , Fibromialgia/complicações , Fibromialgia/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , Osteoartrite do Quadril/complicações , Osteoartrite do Joelho/complicações , Medição da Dor , Índice de Gravidade de Doença , Resultado do Tratamento
15.
J Psychosom Res ; 128: 109868, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31759195

RESUMO

OBJECTIVES: Bodily distress syndrome (BDS) has been shown to encompass a range of functional somatic syndromes (FSS) such as irritable bowel syndrome (IBS), fibromyalgia (FM), and chronic fatigue syndrome (CFS) in clinical samples. This study aimed to explore symptom clusters and test classification of individuals with illness similar to the BDS criteria in a general population sample. METHODS: A stratified subsample of 1590 individuals from the DanFunD part two cohort was included. Symptoms were assessed with the Research Interview for Functional somatic Disorders, performed by trained physicians. In 44 symptoms pooled from criteria of IBS, FM, CFS, and BDS, symptom clusters were explored with explorative factor analysis. Confirmation of symptom clusters of BDS in the previously described 25- and 30-item BDS checklists was performed with confirmatory factor analysis. Classification of individuals into illness groups was investigated with latent class analysis. RESULTS: Four symptom clusters (cardiopulmonary, gastrointestinal, musculoskeletal, general symptoms/fatigue) corresponding to the BDS subtypes and their corresponding FSS were identified and confirmed. A three-class model including 25 BDS items had the best fit for dividing participants into classes of illness: One class with low probability, one class with medium probability, and one class with high probability of having ≥4 symptoms in all symptom clusters. CONCLUSION: The BDS concept was confirmed in the general population and constitutes a promising approach for improved FSS classification. It is highly clinical relevant being the only diagnostic construct defining the complex multi-organ type.


Assuntos
Síndrome de Fadiga Crônica/diagnóstico , Fibromialgia/diagnóstico , Síndrome do Intestino Irritável/diagnóstico , Estudos de Coortes , Análise Fatorial , Feminino , Humanos , Análise de Classes Latentes , Masculino , Pessoa de Meia-Idade
16.
Clin Exp Rheumatol ; 38 Suppl 123(1): 9-16, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31577216

RESUMO

OBJECTIVES: To develop and test in a preliminary way a new self-administered and user-friendly screening tool, called SImple FIbromyalgia Screening (SIFIS) questionnaire, to screen Italian speaking patients for the presence of fibromyalgia (FM). METHODS: The development of the SIFIS questionnaire followed five steps: identification of a specific patient population, item pool development, item reduction, test of the provisional questionnaire, and validation study. The item generation was carried out by a review of the literature on the existing questionnaires. Thirty-three items were identified, and a survey was performed among 139 specialists. The frequency importance product allowed us to select the six most significant items. The validation study allowed the determination of sensitivities, specificities and likelihood ratios (LRs) aiming to calculate the post-test probability of the presence of FM, by applying the Bayesian Analysis Model method. RESULTS: The preliminary testing was performed in 284 subjects with multi-site pain. In 230 (80.9%) of them, FM was diagnosed according to the modified 2010 American College of Rheumatology (ACR) criteria. For each of the six items, LRs varied between 3.37 and 5.00. The best positive LR was found in item 1, exploring persistent pain. The presence of four out of six items gave a post-test probability ≥80% (range: 81.8-87.1%). CONCLUSIONS: The SIFIS questionnaire is a useful tool that can be used for potential screening.


Assuntos
Fibromialgia/diagnóstico , Inquéritos e Questionários , Teorema de Bayes , Humanos , Sensibilidade e Especificidade
17.
Rev. esp. salud pública ; 94: 0-0, 2020. ilus, tab
Artigo em Espanhol | IBECS | ID: ibc-193574

RESUMO

OBJETIVO: El abordaje clínico de la fibromialgia es causa de frustración para algunos profesionales por la controversia en su diagnóstico, etiopatología y manejo clínico. El objetivo del presente estudio fue explorar cuáles son las creencias y conocimientos hacia la fibromialgia por parte de profesionales de distintas especialidades del ámbito público de salud de la provincia de Almería. METODOS: Se trató de un estudio descriptivo y transversal. Se aplicó un cuestionario elaborado ex profeso a una muestra de 103 clínicos de Atención Primaria, Salud Mental, Medicina Interna y Reumatología. Se exploró la relación de las variables mediante la prueba chi-cuadrado. RESULTADOS: El 59,7% de los profesionales de Atención Primaria y el 66,7% de los de Medicina Interna conceptuaron la fibromialgia como una somatización. Asimismo, el 58,9% de los profesionales de Atención Primaria indicó que en ningún caso había de considerarse como una enfermedad discapacitante, en comparación con el 16,7% de los de Reumatología, así como que para el 42,5% no era fundamental su diagnóstico, en comparación a la totalidad en otras especialidades. Los trastornos del ánimo, como entidades de las que resulta difícil de discriminar la fibromialgia, fueron mencionados por el 53,4% de los de Atención Primaria. Los problemas de sueño o problemas gastrointestinales se mencionaron en mayor medida como manifestaciones clínicas entre los de Reumatología (83,3% y 50%, respectivamente). CONCLUSIONES: Un alto porcentaje de profesionales conceptúan la fibromialgia como una entidad psicógena, en especial, profesionales de Medicina Interna y Atención Primaria, destacando en esta última una posición en contra de la consideración de discapacidad y su difícil diferenciación de los trastornos del ánimo. Estos últimos hallazgos podrían explicarse por creencias o actitudes respecto a la amplificación de las conductas del dolor y la obtención de ganancias secundarias. Destacan los conocimientos más profundos de la sintomatología en Reumatología. Se discuten las limitaciones metodológicas y recomendaciones


OBJECTIVE: The clinical approach of fibromyalgia is a cause of frustration for some professionals due to the controversy on its diagnosis, etiopathology and clinical management. The aim of this study was to explore the beliefs and knowledge on fibromyalgia among health professionals from different specialties of the public health service from Almería province. METHODS: A descriptive and cross-sectional study was carried out. A questionnaire prepared ex profeso was applied to a sample of 103 clinicians from Primary Care Physicians, Mental Health, Internal Medicine and Rheumatology. The chi-square test was performed to explore the relationships among variables. RESULTS: 59.7% of Primary Care providers and 66.7% of Internal Medicine conceptualized fibromyalgia as a somatization. Likewise, 58.9% of Primary Care indicated that fibromyalgia should be considered in no case as a disabling illness, compared to 16.7% from Rheumatology, as well as for 42.5% of them the fibromyalgia diagnosis is not essential, compared to the amount of other specialties. Mood disorders were mentioned by 53.4% of Primary Care as entities from which fibromyalgia is difficult to discriminate. Sleep or gastrointestinal problems were mentioned by 83.3% and 50% of Rheumatology professionals, respectively. CONCLUSIONS: A high percentage of professionals considered fibromyalgia as a psychogenic entity, especially among Internal Medicine and Primary Care, highlighting in the last one a position against the consideration of disability and its difficult differentiation from mood disorders. These latest findings could be explained by beliefs or attitudes on the amplification of pain behaviors and secondary gains. A deeper knowledge on fibromyalgia symptoms from Rheumatology is highlighted. Methodological limitations and recommendations are discussed


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Fibromialgia/diagnóstico , Dor Crônica/diagnóstico , Manejo da Dor/métodos , Fibromialgia/psicologia , Conhecimentos, Atitudes e Prática em Saúde , Pessoal de Saúde/estatística & dados numéricos , Atenção Primária à Saúde , Espanha/epidemiologia , Estudos Transversais , Pesquisas sobre Serviços de Saúde/estatística & dados numéricos
18.
Artigo em Inglês | MEDLINE | ID: mdl-33396651

RESUMO

Several studies have emphasized the heterogeneity of fibromyalgia patients. Furthermore, fibromyalgia patients are considered a high-risk suicide group. The ideation-to-action framework proposes a set of transdiagnostic psychological factors involved in the development of suicidal ideation. The present study aims to explore the existence of different subgroups according to their vulnerability to suicidal ideation through these transdiagnostic psychological variables and a set of variables typically associated with fibromyalgia. In this cross-sectional study, 151 fibromyalgia patients were assessed through the Revised Fibromyalgia Impact Questionnaire, Beck Depression Inventory-II, Plutchik Suicide Risk Scale, Interpersonal Needs Questionnaire, Defeat Scale, Entrapment Scale, Psychache Scale, and Beck Hopelessness Scale. A K-means cluster analysis identified two clusters, one (45.70%) according to a low vulnerability, and a second (54.30%) with a high vulnerability to suicidal ideation. These clusters showed statistically significant differences in suicidal ideation and suicide risk. However, no differences were observed in most socio-demographic variables. In conclusion, fibromyalgia patients who present a clinical condition characterized by a moderate-high degree of physical dysfunction, overall disease impact and intensity of fibromyalgia-associated symptoms, along with a high degree of perceived burdensomeness, thwarted belongingness, defeat, entrapment, psychological pain and hopelessness, form a homogeneous group at high risk for suicidal ideation.


Assuntos
Fibromialgia , Ideação Suicida , Estudos Transversais , Feminino , Fibromialgia/complicações , Fibromialgia/diagnóstico , Fibromialgia/psicologia , Humanos , Relações Interpessoais , Masculino , Teoria Psicológica , Fatores de Risco , Suicídio
19.
Rev Esp Salud Publica ; 932019 Dec 13.
Artigo em Espanhol | MEDLINE | ID: mdl-31831726

RESUMO

OBJECTIVE: The elevated prevalence of the fibromyalgia and its polypathologic clinic suppose an important Public Health problem in Spain. The purpose of this study was to carry out an approach of the syndrome's epidemiology, with the finality of collaborate in the scientific knowledge progress of the people who suffer fibromyalgia, in this case, through the sociodemographic analysis of Comunidad Valenciana patients, in Spain. METHODS: It was done an epidemiologic descriptive transversal study, by extractions and analysis of epidemiological variables in official resources of health information of Comunidad Valenciana (Abucasis II, SIA, GAIA, SIP, SIE). The study presented two different analysis processes: the first one was the exam of the fibromyalgia prevalence evolution of the whole Comunidad Valenciana, considering the totality of diagnosed people between 2012 and 2016. The second one, supposed the sociodemographic characterization of people who are affected with fibromyalgia, using a sample of 9,267 people with active diagnostic of the disease in one of the 25 health department of the valencian public system, observing variables such as age, sex, origin, asistenciality, labour activity and economic level. The datum statistic treatment was descriptive univariable and it was made with percentage values of means, median and mode. The confidence interval for the average when required was set at 95 percent. RESULTS: Fibromyalgia was an elevated prevalence disease in Comunidad Valenciana (3.7%) in the study's period, establishing itself above the world media prevalence studied, Europe or Spain. What is more, it presented a special gravity in the male prevalence. Its evolution reflected a growth year-to-year of the order of 28 percent, with an average incidence rate of 5.39 new cases per thousand inhabitants / year. It specially affected women (it had it the 63% of the sample) and the average age of 54 years. Besides, people with fibromyalgia presented low economic levels and laboural difficulties defined by low employment rate, the elevated unemployment rate and the frequency and length of their work leaves. CONCLUSIONS: Fibromyalgia has a special epidemiological importance in Comunidad Valenciana, with a high prevalence and incidence. In its basic sociodemography we found an elevated percent of women with ages between 51 and 70 years, but also, we find a male prevalence of special consideration comparatively with other studies. We observe an important reduce of the socioeconomic and sociodemographic conditions between fibromyalgia diagnosed people.


Assuntos
Fibromialgia/epidemiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Feminino , Fibromialgia/diagnóstico , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Prevalência , Fatores Socioeconômicos , Espanha/epidemiologia , Adulto Jovem
20.
Pain Physician ; 22(6): E579-E585, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31775411

RESUMO

BACKGROUND: Fibromyalgia syndrome (FMS) is a disorder with a population prevalence of 1% to 5%. There are insufficient data in the literature on the incidence of FMS in patients with axial spondyloarthritis (SpA), with only a limited number of studies conducted. OBJECTIVES: The aim of this study was to determine the presence of FMS in patients diagnosed with axial SpA and to investigate the effect of this coexistence on clinical and laboratory assessments in patients with ankylosing spondylitis. STUDY DESIGN: This research involved a retrospective analysis of prospectively collected data. SETTING: The research took place in an outpatient rheumatology clinic. METHODS: This study included 125 patients diagnosed with axial SpA according to the Assessment of Spondyloarthritis International Society criteria. The presence of FMS was investigated according to the 2010 American College of Rheumatology criteria. Pain during activity, resting, and at night was examined using the Visual Analog Scale. Ankylosing Spondylitis Disease Activity Scores were used for assessment of disease activity, Ankylosing Spondylitis Quality of Life Scale was used for quality of life, Bath Ankylosing Spondylitis Functional Index was used for functionality, and Pittsburgh Sleep Quality Index was used for sleep quality. RESULTS: Incidence of FMS was 29.6% in the study population, which consisted of patients who were all diagnosed with axial SpA. Comparison of patient groups with and without FMS revealed no statistically significant differences in age, weight, body mass index, marital status, family history, and smoking history (P > .05), with a higher rate of female patients in the group with FMS at 55% (P < .05). Ankylosing Spondylitis Disease Activity Score-C-Reaktif Protein, Ankylosing Spondylitis Disease Activity Score-Erythyrocyte Sedimentation Rate, Ankylosing Spondylitis Quality of Life Scale, Bath Ankylosing Spondylitis Functional Index, Pittsburgh Sleep Quality Index, and Visual Analog Scale pain scores were significantly higher in the group with FMS (P < .05). LIMITATION: The study involved a limited number of patients. CONCLUSIONS: FMS is observed in one-third of patients with axial SpA. The presence of FMS negatively affects quality of life, functional status, sleep quality, disease activity, and pain level of patients with ankylosing spondylitis. The possibility for coexistence of FMS should be kept in mind when determining the treatment protocols for patients with axial spondyloarthritis, and adjunctive treatment should be given if necessary. KEY WORDS: Disease activity, fibromyalgia, quality of life, spondyloarthritis, sleep quality.


Assuntos
Fibromialgia/epidemiologia , Medição da Dor/métodos , Qualidade de Vida , Espondilartrite/epidemiologia , Espondilite Anquilosante/epidemiologia , Adulto , Feminino , Fibromialgia/diagnóstico , Fibromialgia/psicologia , Humanos , Masculino , Pessoa de Meia-Idade , Medição da Dor/psicologia , Prevalência , Estudos Prospectivos , Qualidade de Vida/psicologia , Estudos Retrospectivos , Índice de Gravidade de Doença , Espondilartrite/diagnóstico , Espondilartrite/psicologia , Espondilite Anquilosante/diagnóstico , Espondilite Anquilosante/psicologia , Escala Visual Analógica , Adulto Jovem
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