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1.
Harefuah ; 158(9): 583-586, 2019 Sep.
Artigo em Hebraico | MEDLINE | ID: mdl-31507109

RESUMO

AIMS: This study aimed to examine a possible association between BMI levels, smoking and socio-economic status and the existence of fibromyalgia. BACKGROUND: Obesity is a worldwide epidemic with devastating impacts on the public's health. There are several indications that obesity might also be involved in the pathogenesis of chronic pain syndromes such as fibromyalgia. METHODS: Patients who were diagnosed with fibromyalgia were compared to population-based controls, matched in age and gender (by a ratio of 1:5). Body mass indices, smoking status and socioeconomic strata were retrieved from computerized medical records of the Clalit Health Services database. Body mass index was classified in WHO categories of underweight, normal, overweight and obese (<18.5, 18.5-<25, 25.0-<30, ≥30.0 kg/m2); χ2, t-tests, and logistic regression models were used to compare the study groups and assess the association between obesity and fibromyalgia. RESULTS: The study included 14,296 patients with fibromyalgia and 71,324 controls. Among patients with fibromyalgia the average BMI (body mass index) was higher than that of the controls 29.1± 6.2 vs. 28.0± 6.01, p<0.001) with every increment of 1 unit of the BMI score, there was an increment of 2.7% of the odds of having coexistent fibromyalgia. The chances of having fibromyalgia was 56% higher among subjects with obesity compared to individuals of normal weight. The data revealed that patients with fibromyalgia smoke more and belong to lower socioeconomic levels. CONCLUSIONS: Our findings demonstrate that obesity is significantly associated with a higher proportion of fibromyalgia. This finding underlines the role that obesity plays in inflammation and chronic pain.


Assuntos
Fibromialgia/epidemiologia , Obesidade/epidemiologia , Fumar/epidemiologia , Índice de Massa Corporal , Humanos , Sobrepeso , Fatores Socioeconômicos
2.
J Shoulder Elbow Surg ; 28(10): 1928-1935, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31401129

RESUMO

HYPOTHESIS: The purpose of this study was to determine the rate of opioid use before and after shoulder stabilization surgery for instability due to recurrent dislocation and assess patient factors associated with prolonged opioid use postoperatively. METHODS: Patients undergoing primary shoulder stabilization procedures for shoulder instability due to recurrent dislocation were accessed from the Humana administrative claims database. Patients were categorized as those who filled 1 or more opioid prescriptions within 1 month, those who filled opioid prescriptions between 1 and 3 months, and those who never filled opioid prescriptions before surgery. Rates of opioid use were evaluated preoperatively and longitudinally tracked for each group. Multiple binomial logistic regression analysis was used to identify factors associated with opioid use at 3 months and 1 year after surgery. RESULTS: Overall, 4802 patients (45.9% opioid naive) underwent shoulder stabilization surgery for shoulder instability during the study period. Rates of opioid use significantly declined after the first postoperative month; however, at 1 year, the rate of opioid use was significantly greater in patients who filled opioid prescriptions preoperatively (13.4% vs. 1.9%, P < .0001). Filling opioid prescriptions 1 to 3 months prior to surgery was the strongest risk factor for opioid use at 1 year after surgery. CONCLUSIONS: Patients who were prescribed opioids 1 to 3 months before surgery had the highest risk of prolonged opioid use following surgery. Obesity, tobacco use, and a preoperative diagnosis of fibromyalgia were independently associated with prolonged opioid use following surgery.


Assuntos
Analgésicos Opioides/uso terapêutico , Instabilidade Articular/cirurgia , Transtornos Relacionados ao Uso de Opioides/epidemiologia , Dor Pós-Operatória/tratamento farmacológico , Luxação do Ombro/cirurgia , Dor de Ombro/tratamento farmacológico , Adulto , Bases de Dados Factuais , Prescrições de Medicamentos/estatística & dados numéricos , Feminino , Fibromialgia/epidemiologia , Humanos , Instabilidade Articular/etiologia , Masculino , Obesidade/epidemiologia , Período Pós-Operatório , Período Pré-Operatório , Fatores de Risco , Luxação do Ombro/complicações , Articulação do Ombro/cirurgia , Dor de Ombro/etiologia , Fumar/epidemiologia , Fatores de Tempo , Estados Unidos/epidemiologia , Adulto Jovem
3.
Pain Res Manag ; 2019: 3190829, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31281557

RESUMO

Juvenile fibromyalgia (JFM) is a chronic pain syndrome with onset in developmental age, characterized by widespread musculoskeletal pain associated with other neurological or nonneurological symptoms. Headache is one of the most frequent comorbid conditions with JFM, but this association is still poorly studied in the juvenile population. The literature review was conducted searching through PubMed, Scopus, and Web of Science with a combination of the following free-text terms: "fibromyalgia," "juvenile fibromyalgia," "headache," "primary headache," "migraine," "children," "adolescents," and "comorbidity." The research resulted only in two specific studies regarding comorbidity JFM + Juvenile Headache (JH). From each study, we extracted data about sample features, clinical characteristics of both JFM and PH, and assessment tools. The clinical approach to JFM and JH should include a complete examination of the main causes of comorbid diseases, thus improving the therapeutic approach to the patient in developmental age.


Assuntos
Fibromialgia/epidemiologia , Cefaleia/epidemiologia , Adolescente , Criança , Comorbidade , Feminino , Humanos , Masculino
4.
Rev Bras Anestesiol ; 69(3): 227-232, 2019.
Artigo em Português | MEDLINE | ID: mdl-31160047

RESUMO

BACKGROUND AND OBJECTIVES: Pain is one of the most common reason for seeking medical care. This study aimed to analyze patients with chronic pain in Maricá, Rio de Janeiro State, Brazil. METHODS: A transversal retrospective study with 200 patients, who were treated in ambulatory care in a public hospital from June 2014 to December 2015. The variables analyzed were: pain intensity, type of pain, anatomical location, diagnosis and treatment. The data were submitted to statistical analysis, the Fisher's exact test was applied, and the probability p was significant when ≤0.05. RESULTS: We analyzed 200 patients with chronic pain, most of them female (83%). Mean age was 58.6±13.01 years old. The patients were classified in groups by age, six groups with ten years of difference between them. Main age range was the 50-59 years old group, with 49 females (32%) and 5 males (15%). About 65.5% of the total of patients (131) had severe pain (Numeric Rating Sacale was 9.01). Mixed pain was predominant, affecting 108 patients (92 females and 16 males, what represents 55% and 47% of the total of females and males, respectively, that participate in the study). The most prevalent anatomical pain (159 patients, 131 females and 28 males) was in the lower limbs. Lower back pain was present in 113 of the 200 patients (94 females and 19 males). In the 30-39, 50-59, 60-69 years old group, the results for pain locations were significant: p=0.01, p=0.0069, p=0.0003, respectively. CONCLUSION: The prevalence of chronic pain was associated with females in 50-59 years old and severe mixed pain. It was located mainly in lower limbs and lumbar region. The most frequent diagnosis was low back pain followed by fibromyalgia. The patients were informed about their disease and treatment.


Assuntos
Assistência Ambulatorial , Dor Crônica/epidemiologia , Fibromialgia/epidemiologia , Dor Lombar/epidemiologia , Adulto , Idoso , Brasil , Dor Crônica/terapia , Estudos Transversais , Feminino , Fibromialgia/terapia , Humanos , Dor Lombar/terapia , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Adulto Jovem
5.
Artigo em Inglês | MEDLINE | ID: mdl-30981530

RESUMO

OBJECTIVE: Fibromyalgia (FM) is characterized by bodywide diffuse and chronic musculoskeletal pain, which, in some patients, can include pain in the masticatory muscles and temporomandibular joints; those patients are defined as having temporomandibular disorders (TMDs). The purpose of this systematic review is to study the association between FM and TMD, as well as the prevalence and characteristics of TMD in patients with FM or the features and prevalence of FM in patients with TMD. STUDY DESIGN: Our bibliographic search was conducted from January 1, 2005, to May 31, 2018, in the MEDLINE database by using its free search engine PubMed and the keywords "fibromyalgia," "temporomandibular joint disorder," and "orofacial pain." RESULTS: Of the 185 studies found in this search, only 19 met the inclusion criteria. These studies showed a high prevalence of TMD in patients with FM. Muscle pain, temporomandibular joint pain, and muscle tenderness on palpation are the most common symptoms. These results suggest an association between TMD and FM; FM can be an etiologic or aggravating factor for TMD, or it may represent a general vulnerability to pain disorders. Besides, the 2 pathologies may share some regional or central mechanisms in common. CONCLUSIONS: The high prevalence of TMD in patients with FM emphasizes the need to consider the signs and symptoms of TMD in the diagnosis of FM to improve pain management in these patients.


Assuntos
Fibromialgia , Transtornos da Articulação Temporomandibular , Comorbidade , Dor Facial , Fibromialgia/epidemiologia , Humanos , Articulação Temporomandibular , Transtornos da Articulação Temporomandibular/epidemiologia
6.
Int J Gynaecol Obstet ; 146(2): 157-163, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-30973964

RESUMO

OBJECTIVE: To estimate the prevalence of fibromyalgia among women with endometriosis and analyze the effect of fibromyalgia on health-related quality of life (HRQoL). METHODS: An observational case-control study conducted at a tertiary hospital in Barcelona between April 2015 and March 2017 among women with deep infiltrating endometriosis (DIE; n=80), women with superficial endometriosis or ovarian endometrioma (non-DIE; n=76), and control women without endometriosis (n=73). Fibromyalgia was assessed via the London Fibromyalgia Epidemiological Study Screening Questionnaire (LFESSQ). HRQoL was evaluated with the 36-Item Short Form (SF-36) questionnaire. The impact of fibromyalgia and other clinical characteristics was assessed by multivariate regression analysis. RESULTS: More women fulfilled the criteria for fibromyalgia in the DIE group than in the non-DIE and control groups by LFESSQ-4 (31 [39%], 12 [16%], and 6 [8%], respectively; P=0.009) and LFESSQ-6 (22 [28%], 8 [11%], and 4 [5%], respectively; P=0.008). The DIE group reported significantly poorer HRQoL for all SF-36 dimensions. Women with DIE who fulfilled the criteria for fibromyalgia had lower physical component scores (-31.6; 95% confidence interval, -50.8 to -12.3; P=0.003). CONCLUSION: The estimated prevalence of fibromyalgia was higher among women with DIE. Women with DIE and positive fibromyalgia screening had lower HRQoL.


Assuntos
Endometriose/epidemiologia , Fibromialgia/epidemiologia , Qualidade de Vida , Adulto , Estudos de Casos e Controles , Feminino , Humanos , Análise Multivariada , Prevalência , Inquéritos e Questionários
7.
Reumatol. clín. (Barc.) ; 15(2): 90-96, mar.-abr. 2019. ilus, tab
Artigo em Espanhol | IBECS | ID: ibc-184355

RESUMO

Objetivos: Describir la metodología del estudio de prevalencia de las enfermedades reumáticas en la población adulta en España, EPISER 2016, así como sus fortalezas y limitaciones. El objetivo del proyecto es estimar la prevalencia de artritis reumatoide (AR), artropatía psoriásica (APs), espondilitis anquilosante (EA), lupus eritematoso sistémico (LES), síndrome de Sjögren (SS), artrosis (de rodilla, cadera, manos, columna cervical y lumbar), fibromialgia, gota y fractura osteoporótica clínica. Material y método: Estudio transversal multicéntrico de base poblacional en el que participan 45 municipios de las 17 comunidades autónomas. La población de referencia está compuesta por adultos de 20 o más años residentes en España. La recogida de información se llevará a cabo mediante encuesta telefónica empleando el sistema Computer Assisted Telephone Interview (CATI). Las sospechas diagnósticas y los diagnósticos autorreferidos serán estudiadas por reumatólogos del hospital de referencia de los municipios seleccionados. Análisis estadístico: se calcularán las prevalencias de enfermedades reumáticas mediante estimadores y sus IC del 95%. Se calcularán factores de ponderación en función de la probabilidad de selección en cada una de las etapas del muestreo. Se tendrá en cuenta la distribución de la población en España según datos del Instituto Nacional de Estadística. Conclusiones: Los cambios sociodemográficos y en hábitos de vida durante los últimos 16 años justifican la realización de EPISER 2016. El estudio ofrecerá datos actualizados de prevalencia en AR, EA, APs, LES, SS, artrosis, fibromialgia, gota y fractura osteoporótica clínica. Los resultados permitirán comparar los datos con estudios de otros países y con el EPISER 2000


Aims: To describe the methodology of the EPISER 2016 (study of the prevalence of rheumatic diseases in adult population in Spain), as well its strengths and limitations. The aim of this study is to estimate the prevalence of rheumatoid arthritis (RA), psoriatic arthritis (PsA), ankylosing spondylitis (AS), systemic lupus erythematosus (SLE), Sjögren's syndrome (SS), osteoarthritis (knee, hip, hands, and cervical and lumbar spine), fibromyalgia, gout and clinical osteoporotic fracture. Material and method: Population-based, multicenter, cross-sectional study, with the participation of 45 municipalities in the 17 Spanish autonomous communities. The reference population will consist of adults aged 20 years and over residing in Spain. A computer-assisted telephone interview (CATI) system will be used for data collection. Diagnostic suspicions and diagnoses received by the participants will be studied by rheumatologists in the referral hospitals in the selected municipalities. Statistical analysis: the prevalence of the rheumatic diseases will be calculated using estimators and their 95% confidence intervals. Weights will be calculated in each of the sampling stages in accordance with the probability of selection. The distribution of the population in Spain will be obtained from the Spanish Statistics Institute. Conclusions: Sociodemographic and lifestyle changes over the last 16 years justify EPISER 2016. This study will provide current data about the prevalences of RA, AS, PsA, SLE, SS, osteoarthritis, fibromyalgia, gout and clinical osteoporotic fracture. The results will allow comparisons with studies from other countries and EPISER 2000


Assuntos
Humanos , Adulto , Doenças Reumáticas/epidemiologia , Gota/epidemiologia , Artropatias/epidemiologia , Síndrome de Sjogren/epidemiologia , Fibromialgia/epidemiologia , Lúpus Eritematoso Sistêmico/epidemiologia , Artrite Reumatoide/epidemiologia , Espondilite Anquilosante/epidemiologia , Artrite Psoriásica/epidemiologia , Espanha/epidemiologia , Estudos Transversais/métodos
8.
J Pak Med Assoc ; 69(3): 389-398, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30890833

RESUMO

OBJECTIVE: The study aimed to evaluate literature on rheumatoid arthritis disease in Pakistani patients, to have an understanding about its epidemiology, clinical aspects and socio-economic determinants. METHODS: The review study was conducted from December 2017, to May 2018. An online search was conducted in international and local health databases using appropriate search keywords as well as scanning reference lists of related articles. Literature published after year 2000 that reported epidemiological, demographic, clinical and socioeconomic data of Pakistani rheumatoid arthritis patients was included. Meta-analysis was performed where possible. This systematic review was registered on the international prospective register of systematic reviews PROSPERO (CRD42018090582). RESULTS: Of the 334 research articles found, 29 (8.7%) were selected. Patients were mostly females, but no study explored impact of disease on household and family role functioning of rheumatoid arthritis-affected women in Pakistan. Most patients were uneducated (55%) and unemployed; had low disease knowledge (N = 149, 74.5%) and poor adherence to disease-modifying anti-rheumatic drugs (N = 23, 23%). Point prevalence of rheumatoid arthritis reported from Karachi was high at 26.9%. Moderate disease activity, i.e., 4.5}0.7 and mild functional disability (N = 66, 51.6%) were seen in RA patients. Almost half (N = 799, 46.9%) had comorbidities. Almost a fifth proportion of RA patients had dyslipidaemia as a comorbidity (N = 134, 16.77%) and higher cardiovascular risk score as modifiable risk factor. Undiagnosed depression (N = 134, 58.3%) and low bone mineral density (N = 93, 40.6%) were reported in RA patients. Direct monthly treatment cost of disease was significantly high considering patients' socio-economic status, i.e., USD 16.47 - 100.68. Most commonly used drug was methotrexate. CONCLUSIONS: There is a paucity of data on Pakistani rheumatoid arthritis patients' demographic and socio-economic parameters, especially the gender element.


Assuntos
Artrite Reumatoide/epidemiologia , Antirreumáticos/economia , Antirreumáticos/uso terapêutico , Artrite Reumatoide/tratamento farmacológico , Artrite Reumatoide/economia , Doenças Ósseas Metabólicas/epidemiologia , Doenças Cardiovasculares/epidemiologia , Comorbidade , Efeitos Psicossociais da Doença , Depressão/epidemiologia , Transtorno Depressivo/epidemiologia , Fibromialgia/epidemiologia , Metotrexato/economia , Metotrexato/uso terapêutico , Osteoporose/epidemiologia , Paquistão/epidemiologia , Prevalência , Fatores de Risco , Classe Social
9.
J Affect Disord ; 245: 1098-1105, 2019 02 15.
Artigo em Inglês | MEDLINE | ID: mdl-30699852

RESUMO

BACKGROUND: It is acknowledged that fibromyalgia (FM) as a medical (rheumatological) disorder and major depressive disorder (MDD) as a mental disorder often co-occurs, but the inconsistency is prevailing at study-level and no overall estimate of the co-occurrence exist. AIMS: This systematic review and meta-analysis aimed to estimate the overall point- and life-time prevalence of MDD among FM patients based on structured clinical interviews (SCI); and to estimate the point-prevalence of MDD among FM patients based on screening symptom scales (SSS). METHOD: The electronical databases MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials (CENTRAL), and PsycINFO were searched for papers that reported on prevalence of MDD among FM patients. Eligible studies were included in a random effects meta-analysis pooling the prevalence of depression. RESULTS: The literature search identified 11 eligible studies for the meta-analysis. For SCI, the overall pooled point-prevalence (PP) was 25% (95% CI 19 to 31%), and life-time prevalence (LP) was 65% (95% CI 59 to 71%). When estimating the PP with self-administered SSS the overall pooled PP was 45% (95% CI 32 to 59%), and a single clinician-administered SSS yielded a PP of 23% (95% CI 10 to 41%). There was low inconsistency for the SCI and high inconsistency for the SSS. CONCLUSION: One fourth of all FM patients had MDD, and more than half experienced MDD during their life-time according to clinician-administered instruments. Prevalence of MDD was almost twice as high when using self-administered symptom scales and may be likely to overestimate the co-occurrence.


Assuntos
Transtorno Depressivo Maior/epidemiologia , Fibromialgia/epidemiologia , Humanos , Prevalência
10.
J Clin Neuromuscul Dis ; 20(3): 103-110, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30801480

RESUMO

OBJECTIVE: To assess the intraepidermal nerve fiber density in patients diagnosed with fibromyalgia (FM) and to evaluate the role of IgM binding to trisulfated heparin disaccharide (TS-HDS) in these patients. METHODS: FM is a poorly understood pain disorder with several proposed pathophysiologic mechanisms. It is characterized by widespread pain, fatigue, and sleep abnormalities. Small fiber neuropathy (SFN) has been proposed as an underlying mechanism, and patients with FM have been shown to have a reduction in the intraepidermal nerve fiber density. An underlying inflammatory process that could be a result of autoimmune phenomena has also been suggested. Non-length-dependent SFN (NLDSFN) has been shown to have a higher incidence of autoimmune disease. Twenty-two patients with established diagnosis of FM underwent skin biopsy at 2 sites; 10 cm above the lateral malleolus and 10 cm above the patella. Serum IgM binding to TS-HDS was assayed using an ELISA method. RESULTS: A total of 5/22 patients had positive TS-HDS antibodies; of these, 4 had NLDSFN (P = 0.0393). Comparison with a control group at Washington University showed no significant difference in percentage with TS-HDS antibodies (P = 0.41). When compared with Washington University database of skin biopsy, there was a trend for an increased percentage of NLDSFN in patients with FM (P = 0.06). CONCLUSIONS: This study further supports the hypothesis that a subgroup of patients with FM has SFN. We suggest a correlation between the presence of NLDSFN and TS-HDS antibodies.


Assuntos
Dissacarídeos/metabolismo , Fibromialgia/complicações , Fibromialgia/epidemiologia , Heparina/análogos & derivados , Imunoglobulina M/farmacologia , Neuropatia de Pequenas Fibras/epidemiologia , Neuropatia de Pequenas Fibras/etiologia , Adulto , Anticorpos Monoclonais/sangue , Dissacarídeos/imunologia , Feminino , Heparina/metabolismo , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Ligação Proteica
11.
Arthritis Care Res (Hoboken) ; 71(3): 343-351, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30724039

RESUMO

OBJECTIVE: Recent studies have suggested that fibromyalgia is inaccurately diagnosed in the community, and that ~75% of persons reporting a physician diagnosis of fibromyalgia would not satisfy published criteria. To investigate possible diagnostic misclassification, we compared expert physician diagnosis with published criteria. METHODS: In a university rheumatology clinic, 497 patients completed the Multidimensional Health Assessment Questionnaire (MD-HAQ) and the 2010 American College of Rheumatology preliminary diagnostic criteria modified for self-administration during their ordinary medical visits. Patients were evaluated and diagnosed by university rheumatology staff. RESULTS: Of the 497 patients, 121 (24.3%) satisfied the fibromyalgia criteria, while 104 (20.9%) received a clinician International Classification of Diseases (ICD) diagnosis of fibromyalgia. The agreement between clinicians and criteria was 79.2%. However, agreement beyond chance was only fair (κ = 0.41). Physicians failed to identify 60 criteria-positive patients (49.6%) and incorrectly identified 43 criteria-negative patients (11.4%). In a subset of 88 patients with rheumatoid arthritis (RA), the kappa value was 0.32, indicating slight to fair agreement. Universally, higher polysymptomatic distress scores and criteria-based diagnosis were associated with more abnormal MD-HAQ clinical scores. Women and patients with more symptoms but fewer pain areas were more likely to receive a clinician's diagnosis than to satisfy fibromyalgia criteria. CONCLUSION: There is considerable disagreement between ICD clinical diagnosis and criteria-based diagnosis of fibromyalgia, calling into question ICD-based studies. Fibromyalgia criteria were easy to use, but problems regarding clinician bias, meaning of a fibromyalgia diagnosis, and the validity of physician diagnosis were substantial.


Assuntos
Centros Médicos Acadêmicos/normas , Instituições de Assistência Ambulatorial/normas , Erros de Diagnóstico , Fibromialgia/diagnóstico , Papel do Médico , Centros Médicos Acadêmicos/métodos , Adulto , Idoso , Erros de Diagnóstico/psicologia , Feminino , Fibromialgia/epidemiologia , Fibromialgia/psicologia , Humanos , Masculino , Pessoa de Meia-Idade , Medição da Dor/métodos , Medição da Dor/normas , Papel do Médico/psicologia
12.
Clin Exp Rheumatol ; 37 Suppl 116(1): 21-26, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30652679

RESUMO

OBJECTIVES: Fibromyalgia syndrome (FM), characterised by widespread pain and fatigue, has frequently been associated with stress in various models, including workplace related stress. In the current study we have evaluated the prevalence of FM symptoms among Israeli school teachers and have attempted to correlate such symptoms with work-related stress. METHODS: Individuals, all currently employed as school teachers in Israel, were recruited to the study. Participants were asked to answer a questionnaire evaluating symptoms of FM, based on the current diagnostic criteria, which include the widespread pain index (WPI) and the symptom severity scale (SSS). Participants were further questioned regarding stressful experiences during their work and about post-traumatic symptoms as well as regarding work performance and motivation. RESULTS: 321 participants were recruited (79.4% female, 20.6 male). 30 individuals (9.3%) of the sample fulfilled current criteria for a diagnosis of FM, with a rate of 11.4% among females and 1.5% among males. While specific symptoms such as fatigue and irritable bowel symptoms were negatively correlated with work performance, no significant difference was found between teachers with or without fibromyalgia regarding work attendance and performance. FM symptoms were strongly correlated with work-related stress and were strongly correlated with post-traumatic stress disorder (PTSD) related symptoms. Motivation to work was significantly lower among teachers fulfilling FM criteria, but other performance-related parameters did not differ between teachers fulfilling or not fulfilling FM criteria. CONCLUSIONS: Fibromyalgia symptoms are highly prevalent among Israeli school teachers, and may be related to stress encountered in the classroom. These results are relevant both for physicians treating individuals involved in educational careers as well as for educators and decision-makers involved in planning and managing educational strategies.


Assuntos
Fibromialgia , Professores Escolares/estatística & dados numéricos , Feminino , Fibromialgia/epidemiologia , Fibromialgia/psicologia , Humanos , Israel/epidemiologia , Masculino , Prevalência , Professores Escolares/psicologia , Índice de Gravidade de Doença , Estresse Psicológico , Inquéritos e Questionários
13.
Clin Exp Rheumatol ; 37 Suppl 116(1): 58-62, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30620293

RESUMO

OBJECTIVES: To examine cross-sectional and longitudinal relationships between fibromyalgia (FM) and rheumatoid arthritis (RA) disease activity. METHODS: 636 patients in the observational Oslo RA register (ORAR) were invited to a clinical examination in 1999. 28-tender and swollen joint counts (TJC, SJC) and 18-tender points were assessed, the RA disease activity score (DAS-28) calculated. Fibromyalgia (FM) was diagnosed according to 1990 (FM-1990) and modified 2011 (mFM-2011) ACR criteria. At the 10-year follow-up patients completed the RA Disease Activity Index (RADAI) and Routine Assessment of Patient Index Data 3 (RAPID-3). Baseline and 10-year RA disease activity were compared across presence/absence of FM. Linear regression models were constructed with 10-year RADAI and RAPID-3 as outcome. RESULTS: 502 patients participated at baseline data-collection and 10-year data was available in 236. At baseline, mean (SD) age was 59.5 (12.5) years and 87% were female. 9% and 30% had FM-1990 and mFM-2011 respectively. RA-FM patients were predominantly female with higher SJC, TJC, and DAS-28 at baseline. Baseline RA-FM predicted higher levels of RADAI and RAPID-3 at the 10-year follow-up. CONCLUSIONS: RA-FM was associated with significantly higher levels of cross-sectional and longitudinal RA disease activity. FM should be considered in patients with RA not reaching remission.


Assuntos
Artrite Reumatoide/epidemiologia , Fibromialgia/epidemiologia , Estudos Transversais , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Noruega/epidemiologia , Sistema de Registros , Índice de Gravidade de Doença
15.
Clin Exp Rheumatol ; 37 Suppl 116(1): 39-43, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-29745889

RESUMO

OBJECTIVES: Fibromyalgia (FM) is defined as a severe, chronic, non-articular rheumatic condition characterised by widespread musculoskeletal pain, hyperalgesia and generalised tender points, in the absence of inflammatory or structural musculoskeletal abnormalities. Pain is the predominant symptom, allodynia and hyperalgesia are common signs. Extreme fatigue, impaired cognition and non-restorative sleeping difficulties coexist in addition to other somatic symptoms. Several studies suggest there is a meaningful relationship between FM and the psychological symptoms of depression and post-traumatic stress disorder (PTSD). PTSD is a mental disorder that can develop after a person has been exposed to a traumatic event, characterised by a specific set of symptoms including re-experiencing of the event, avoidance and numbing and arousal. The present study investigates the impact of lifetime potentially traumatic events, including losses, and of post-traumatic stress symptoms on the severity of illness in patients with fibromyalgia (FM). METHODS: Sixty-one patients with FM, diagnosed according to the American College of Rheumatology criteria, were consecutively enrolled at the Unit of Rheumatology, University of Pisa, Italy. Assessments included: the SCID-5 and the Trauma and Loss Spectrum Self-Report (TALS-SR) lifetime version. RESULTS: 21.3% of the subjects (n=13) met the criteria for "partial" PTSD: 57.4% criterion B, 42.6% criterion C, 31.1 criterion D and 44.3% criterion E. Fibromyalgia patients without PTSD reported significantly lower scores in all domains compared to the patients with partial PTSD, the latter ones reporting significantly lower scores in all domains compared to full PTSD with the exception of domain I. In particular, these differences were noticeable in Domain VI and Domain VIII. CONCLUSIONS: The results of the study show that fibromyalgic patients with PTSD report more potentially traumatic events, avoidance symptoms, numbing, arousal, maladaptive coping and personality characteristics compared to patients with partial or without PTSD; these results could indicate that loss and/or trauma events represent a risk factor for the development of symptoms of FM in genetically predisposed individuals.


Assuntos
Fibromialgia , Transtornos de Estresse Pós-Traumáticos , Comorbidade , Depressão/epidemiologia , Depressão/psicologia , Fibromialgia/epidemiologia , Fibromialgia/psicologia , Humanos , Itália/epidemiologia , Dor , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Transtornos de Estresse Pós-Traumáticos/psicologia
16.
Musculoskeletal Care ; 17(1): 3-12, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30350334

RESUMO

OBJECTIVE: Consistent terminology to describe the diagnostic criteria for fibromyalgia (FM) and myofascial pain syndrome (MPS) is required to address the reported inadequacies in diagnosis. The present review investigated intervention studies in FM and MPS populations to determine the lexicon of the current diagnostic criteria used to identify chronic musculoskeletal pain patients. METHODS: Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we conducted a scoping review to review systematically the literature obtained from five scientific databases between 1997 and February 2017. Included studies consisted of intervention studies that involved symptomatic musculoskeletal pain patients, of any age or gender, presenting with FM or MPS. Included studies were evaluated for musculoskeletal condition and the diagnostic criteria used to identify patient conditions. Extraction of study criteria focused on whether diagnostic criteria were explicitly stated, the diagnostic criteria used, physical findings, symptomatic duration and the profession of the healthcare provider who confirmed diagnosis. RESULTS: We identified 493 interventions, of which 410 were related to FM and 83 to MPS. The lexicon of the diagnostic criteria used for MPS tended to be less consistent in comparison to FM criteria, with notable differences in all comparative categories. CONCLUSIONS: The current review identified inconsistencies associated with the lexicon of the diagnostic criteria used to diagnose FM and MPS, and showed that there is wide variability in the terminology currently being used. These findings may have important implications for future development of consistent criteria to diagnose FM and MPS patients accurately.


Assuntos
Fibromialgia/diagnóstico , Síndromes da Dor Miofascial/diagnóstico , Diagnóstico Diferencial , Fibromialgia/epidemiologia , Humanos , Síndromes da Dor Miofascial/epidemiologia , Medição da Dor
17.
J Back Musculoskelet Rehabil ; 32(1): 119-124, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30248041

RESUMO

BACKGROUND: For treatment of chronic musculoskeletal disorders pains to be successful, drug interventions are required. OBJECTIVE: In this study, we aimed to evaluate the Rational Drug Use Knowledge Level (RDUKL) in patients with musculoskeletal disorders and some relevant factors. METHOD: The study was carried out in October 2017 on patients treated in the Physical Therapy Rehabilitation Hospital in Turkey. The prepared questionnaire and RDUKL scale were administered to 239 patients by face-to-face interviews. The ANOVA test, chi-squared test and logistic regression model were used for the statistical evaluation. RESULTS: Forty-three percent of the study group was found to have Rational Drug Use Knowledge (RDUK). The patients who used medicines under family supervision had twice as much RDUK as those who did not use medicines under family supervision, and those who were university graduates had six times as much RDUK as those who had primary education or below. Scale score was found to be low in patients with fibromyalgia and high in patients with rheumatoid arthritis (p< 0.05). CONCLUSION: RDUKL was found to be low in the group with chronic diseases and high average age. Besides training, it is important to provide patients with family support about their illness and its treatment. Thus, positive contributions can be made to the increase of the RDUKL.


Assuntos
Analgésicos/uso terapêutico , Conhecimentos, Atitudes e Prática em Saúde , Doenças Musculoesqueléticas/tratamento farmacológico , Doenças Musculoesqueléticas/epidemiologia , Adulto , Fatores Etários , Artrite Reumatoide/tratamento farmacológico , Artrite Reumatoide/epidemiologia , Escolaridade , Feminino , Fibromialgia/tratamento farmacológico , Fibromialgia/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Inquéritos e Questionários , Turquia/epidemiologia
18.
Clin Rheumatol ; 38(1): 165-172, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30284078

RESUMO

The prevalence of fibromyalgia (FM) in physicians in training (PIT) in Saudi Arabia is unknown. The aim of this study is to evaluate the prevalence of FM in PIT using different screening tools and factors associated with its development. We also aimed at evaluating the level of agreement and correlation between screening tools. This was a cross-sectional study conducted in a single academic institution. PIT were invited to fill three questionnaires: Fibromyalgia Rapid Screening tool (FirST), Fibromyalgia Survey Questionnaire (FSQ), and London Fibromyalgia Epidemiology Study Screening Questionnaire (LFESSQ). A total of 182 PIT completed the questionnaire. They were predominantly males (57.1%), single (56.0%), and at resident level (86.7%). The median age was 28 (interquartile range = 4). The average number of house-calls/month was 3.2 (SD = 2.3). The prevalence of FM using the FirST, FSQ, and LFESSQ was 6.0%, 8.2%, and 11.6%, respectively. Six (3.3%) fulfilled the three criteria concurrently. After adjusting for different variables using the FSQ, PIT with family history of FM had 23.6 times the odds for testing positive (95% CI = 3.12, 178.37), and every extra house-call/month was associated with a 50% increase in the odds for testing positive for FM (95% CI = 1.00, 2.25). Percent agreement between tools was high (all > 86%). Results for kappa coefficient showed moderate agreement between FSQ scores and each of FirST and LFESSQ. There was poor agreement between FirST and LFESSQ. FM is prevalent among PIT. There is a high percent agreement and poor to moderate correlation between the screening tools used.


Assuntos
Fibromialgia/epidemiologia , Programas de Rastreamento/métodos , Médicos/estatística & dados numéricos , Qualidade de Vida , Adulto , Estudos Transversais , Feminino , Humanos , Internato e Residência , Modelos Logísticos , Masculino , Prevalência , Arábia Saudita/epidemiologia , Inquéritos e Questionários , Adulto Jovem
19.
Clin Exp Rheumatol ; 37 Suppl 116(1): 51-57, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30299249

RESUMO

OBJECTIVES: The current provisional diagnostic criteria for the fibromyalgia syndrome (FM) include a cognitive index score (SSS-Cog), which constitutes a part of the Symptom Severity Scale (SSS). The current study aimed at assessing the validity of the cognitive index score, by comparing this subjective measure of cognitive impairment with an objective measure of cognitive functioning, collected through comprehensive computerised cognitive testing and assessment. METHODS: 50 FM patients underwent a computerised cognitive assessment battery, including testing in domains of memory, executive function, attention and information processing speed (NeuroTraxCorp.). Age and education standardised scores were computed. FM symptoms were assessed by the Fibromyalgia Impact Questionnaire (FIQ), Widespread Pain Index (WPI) and Symptom Severity Scale (SSS), a Visual Analog Scale (VAS) of clinical pain and the Beck Depression inventory (BDI-II). RESULTS: The index score for subjective assessment of cognitive decline (SSS-Cog) was not correlated with any of the objective cognitive measures. However, a positive correlation was found between the SSS-Cog and the FIQ, the WPI and the VAS measures, all reflecting subjective overall functional ability. CONCLUSIONS: No significant relationship was found between FM patients' subjective appraisal of cognitive deficit and objective cognitive scores on all computerised subtests. However, subjective appraisal of cognitive impairment was found to be strongly and significantly related to patients' functional ability. Therefore, we suggest reconsidering the definition of this index score (SSS-Cog) and propose developing novel and more accurately defined tools in order to measure cognitive impairment in FM patients, for both diagnostic and epidemiological purposes.


Assuntos
Transtornos Cognitivos/epidemiologia , Fibromialgia , Cognição/fisiologia , Fibromialgia/epidemiologia , Fibromialgia/psicologia , Humanos , Medição da Dor , Índice de Gravidade de Doença , Inquéritos e Questionários
20.
Psychol Health Med ; 24(2): 207-220, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-30270643

RESUMO

To determine whether the effects of symptom duration on fibromyalgia physical impairment are moderated by symptom self-efficacy, data from 572 female participants, who were members of a large health maintenance organization and had a diagnosis of fibromyalgia syndrome (FMS) were assessed. Age, symptom duration, history of physical, sexual, and emotional abuse, fibromyalgia-specific self-efficacy (Arthritis Self-Efficacy Scale adapted for FMS [ASES]), depression (Centers for Epidemiological Studies Depression Scale [CES-D]), fibromyalgia physical impairment (Fibromyalgia Impact Questionnaire [FIQ]), and pain (McGill Present Pain Index [PPI]) were measured five times across 18 months. Linear regressions were performed to predict baseline FIQ and PPI cross-sectionally. Of primary interest was a hypothesized interaction between ASES and symptom duration, which was significant in relation to FIQ but not PPI. Multilevel mixed models were performed to determine whether the same pattern existed longitudinally controlling for baseline symptom duration as an effect of time and ASES. The interaction was significant in the models for both FIQ and PPI. These results suggest that the effects of age and symptom duration on FMS are unique, and that self-efficacy plays a crucial role in moderating disease course (measured by symptom duration or time) in FMS.


Assuntos
Progressão da Doença , Fibromialgia/epidemiologia , Fibromialgia/fisiopatologia , Autoeficácia , Adolescente , Adulto , Fatores Etários , Idoso , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Tempo , Adulto Jovem
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