scholarly journals THU0462 CHARACTERIZATION OF PATIENTS WITH FIBROMYALGIA AFFECTS WITH OR WITHOUT JOINT HYPERLAXITY SYNDROME

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 468.1-468
Author(s):  
L. López-Núñez ◽  
J. Blanch ◽  
M. Ciria Recasens ◽  
M. J. Herrero Gascón ◽  
A. Juan-Mas ◽  
...  

Background:The prevalence of joint hypermobility (JH) and Joint Hypermobility Syndrome (JHS) in patients with fibromyalgia (FM) is considerable and is much more than can be explained at random(1). Some authors propose that FM and JHS share a common pathophysiological mechanism is some patients. Currently it is accepted that Ehlers-Danlos Syndrome Hypermobility subtype (EDSh) and JHS are the same entity. We regard the subgroup of FM patients with JHS a different subtype of FM, even phenotypically similar to EDSh.Objectives:Determine the possible differences between both groups according to their body composition, bone metabolism and clinical findings.Methods:Our study is observational, descriptive, transverse cohort study in which we included 86 women with fibromyalgia recruited at the Fibromyalgia and Chronic Fatigue Unit at Parc Salut-Mar in Barcelona, Spain. The patients were grouped according to the presence or absence of JHS, following the Brighton Criteria. Diverse clinical data was collected: Pain Visual Analogue Scale (PVAS), time from pain onset, time from diagnosis, somatic symptoms, state of mind, presence of a FM trigger, concurrent medication, anxiety, quality of life, disease impact, anthropometric data, Bioelectrical Impedance Analysis (BIA), bone density test (BMD) and bone metabolism data in blood samples.Results:51 patients were included in the FM group and 35 patients in the FM-JHS group. We did not find differences between groups PVAS; time from pain onset; somatic symptoms using the Psychiatric Disorder and Somatic Pathology Scale (TOPYPS); nor Fibromyalgia Impact Questionnaire (FIQ). Both groups scored similarly on SF-36 Health Questionnaire. The use of opioids was more common in the FM group (p<0,001). Anxiety disorder (AnD) was present in a greater proportion of FM-JHS (p<0,001). We found the Body Mass Index and Muscle Mass (MM) to be less in the FM-JHS group (p=0.001 and p=0.008, respectively). Obesity and fat mass (FatM) were more frequent in the FM group. The FatM and less MM correlated with less quality of life on the SF-36 scale. There was less bone mass (BM) in the FM-JHS group (p=0.005). We found an inverse correlation between the Beighton score and the MM and BM in the FM-JHS group. The FM-JHS group also had less bone mineral density (BMD) at total hip DXA, with significant differences p=0.038. The BM by Bioelectrical Impedance Analysis (BIA) had a positive correlation on the BMD by DXA. The optimum point, capable of distinguishing between normal DXA and osteopenia/osteoporosis was 2,325kg with a specificity of 86% and sensibility of 52%. Vitamin D deficiency/insufficiency was found in 62/84 (73,8%) without significant differences between groups (p>0,05)Conclusion:Our work revealed that FM patients with JHS are different from FM without JHS, by manifesting differences in certain clinical, anthropometric, and bone metabolism features.References:[1]Lai S, Goldman JA, Child AH, Engel A, Lamm SH. Fibromyalgia, hypermobility, and breast implants. J Rheumatol. 2000;27(9):2237-41.[2]Malfait, F., Francomano, C., Byers, P., Belmont, J., Berglund, B., Black, J., ... & Castori, M. (2017, March). The 2017 international classification of the Ehlers–Danlos syndromes. InAmerican Journal of Medical Genetics Part C: Seminars in Medical Genetics(Vol. 175, No. 1, pp. 8-26).Disclosure of Interests: :None declared

2012 ◽  
Vol 22 (6) ◽  
pp. 1081-1088 ◽  
Author(s):  
Marta Novackova ◽  
Michael J. Halaska ◽  
Helena Robova ◽  
Ivana Mala ◽  
Marek Pluta ◽  
...  

BackgroundLower-limb lymphedema is one of the most disabling adverse effects of vulvar cancer surgery. Multifrequency Bioelectrical Impedance Analysis (MFBIA) is a modern noninvasive method to detect lymphedema. The first aim of this study was to prospectively determine the prevalence of secondary lower-limb lymphedema after surgical treatment for vulvar cancer using objective methods, circumference measurements and MFBIA technique. The second aim was to compare quality of life (QoL) before and 6 months after vulvar surgery.MethodsTwenty-nine patients underwent vulvar cancer surgery in our study: 17 underwent inguinofemoral lymphadenectomy (RAD), and 12 underwent sentinel lymph node biopsy (CONS). Patients were examined before and 6 months after vulvar surgery by measuring the circumference of the lower limbs and with MFBIA. A control group of 27 healthy women was also measured. To evaluate QoL, the European Organisation for Research and Treatment of Cancer (EORTC) QoL questionnaires (QLQ-C30 and QLQ-CX24) were administered to patients before and 6 months after surgery.ResultsUsing circumference measurement, 9 lymphedemas (31%) were diagnosed: 3 (25%) in the CONS and 6 (37.5%) in the RAD group (P= 0.69). After vulvar surgery, patients in the RAD group reported more fatigue and worsening of physical and role functioning. When comparing both groups, the RAD group had significantly worse parameters in social functioning, fatigue, and dyspnea.ConclusionsLower radicality in inguinofemoral lymphadenectomy shows a trend toward lower morbidity and significantly improves QoL. Multifrequency Bioelectrical Impedance Analysis was tested in these patients as a noninvasive, objective method for lymphedema detection. Detection of lymphedema based on subjective evaluations proved to have an unsatisfactory sensitivity. Less radical surgery showed objectively better results in QoL.


2020 ◽  
Vol 30 (12) ◽  
pp. 1975-1982
Author(s):  
Melisa Guelhan Inci ◽  
Rolf Richter ◽  
Hannah Woopen ◽  
Julia Rasch ◽  
Kathrin Heise ◽  
...  

BackgroundSurgery for gynecological cancer involves highly invasive and complex procedures potentially associated with various complications, which can cause extended hospital stays and delay of subsequent therapy, with a detrimental effect on the prognosis. The aim of this study was to explore and define the predictors of severe postoperative complications in patients undergoing surgery for gynecologic cancer.MethodsPatients undergoing surgery for gynecologic cancers were analyzed prospectively from October 2015 through January 2017. Using validated assessment tools preoperatively, we assessed comorbidities, performance status, quality of life, nutritional and body composition by bioelectrical impedance analysis, and the surgical data of each patient. Surgical complications were graded using the Clavien-Dindo criteria. Using stepwise logistic regression models, we identified predictive markers for postoperative complications.ResultsOf the 226 enrolled patients, 40 (17.7%) experienced a grade ≥IIIb complication according to the Clavien-Dindo criteria. In the regression analysis, overweight/obesity (body mass index >25) (OR 6.41, 95% CI 2.38 to 17.24; p<0.001) and impaired physical functioning defined by a quality of life questionnaire (OR 4.19, 95% CI 1.84 to 9.50; p=0.001) emerged as significant predictors of postoperative complications. Moreover, postoperative complications were predicted by phase angle of bioelectrical impedance analysis <4.75° (OR 3.11, 95% CI 1.35 to 7.16; p=0.008) and Eastern Cooperative Oncology Group (ECOG) performance status >1 (OR 2.51, 95% CI 1.06 to 5.92; p=0.04). Intraoperative factors associated with higher risk of postoperative complications were increased use of norepinephrine (>11 µg/kg/min) (OR 5.59, 95% CI 2.16 to 14.44; p<0.001) and performance of large bowel resection (OR 4.28, 95% CI 1.67 to 10.97; p=0.002).ConclusionIn patients undergoing surgery for gynecological cancer, preoperative evaluation of performance status according to ECOG, domains of quality of life and nutritional status, as well as intraoperative monitoring of risk factors, might help to identify patients at high risk for severe postoperative complications, and thus reduce surgical morbidity and mortality.


2017 ◽  
Vol 2017 ◽  
pp. 1-10 ◽  
Author(s):  
Halina Cichoż-Lach ◽  
Agata Michalak

It is assumed that approximately 24–66% of patients with liver cirrhosis develop malnutrition. Numerous pathological processes lead to serious disorders of nutritional status in this group of patients. Malnutrition in the course of liver cirrhosis is associated with increased morbidity, complications, and low quality of life. Under these conditions, detection of malnutrition is of crucial importance. This review explores the complex mechanisms that lead to malnutrition in the course of liver cirrhosis and focuses on methods used in the assessment of nutritional status in cirrhotic patients. Among others, the role of bioelectrical impedance is highlighted. This noninvasive tool is promising and quite an accurate method of estimating body composition.


2017 ◽  
Vol 41 (S1) ◽  
pp. S537-S538
Author(s):  
A.L. Pérez Morenilla ◽  
A. Salazar ◽  
I. Failde ◽  
J.A. Mico

Depressive Disorder, according to WHO will be one of the most disabling causes in the world. Depression includes psychological and somatic symptoms, like anhedonia or pain, and both have a bidirectional relationship, so that the presence and severity of one of them directly affects the other one, and both leads to a disruption in quality of life and increase health resources. The relationship between major depression and chronic pain has been widely investigated but few studies have focused on other depressive spectrum disorders, and never the possible relationship between pain and anhedonia in DD. Our aim is to analyse the presence of somatic symptoms (especially pain) in patients with DD and its impact on quality of life, and involvement with anhedonia. We analysed the correlation between the scores of the HADS, SSI-28, SHAPS and SF-36 scales. Results showed a significant correlation between SSI-28 and HADS-A(r = 0.45; P < 0.001), HADS-D(r = 0.35; P < 0.001) and with 7 of the 8 domains of SF-36: Bodily Pain(r = –0.62; P < 0.001), General Health(r = –0.29; P = 0.003), Role Physical(r = –0.45; P < 0.001) Mental Health(r = –0.34; P = 0.003), Vitality(r = –0.403; P < 0.001), Social Functioning(r = –0.37; P < 0.001). In addition, SHAPS correlates with 6 of the 8 domains of SF-36: PF(r = –0.33; P = 0.001), GH(r = –0.27; P = 0.006), Vit (r = –0.41; P < 0.001), SF(r = –0.52; P < 0.001), RE(r = –0.24; P < 0.001) and MH(r = –0.49; P < 0.001). The results demonstrate that both anhedonia and somatic symptoms negatively correlate with HRQoL, and that a bidirectional relationship between depression and somatic symptoms is clearly proven, which means that depression may be related with the presence of somatic symptoms, especially pain, and also somatic symptoms lead to an increase of depressive symptoms. This could impact on the diagnosis and treatment of depressed patients with somatic symptoms and anhedonia.Disclosure of interestThe authors have not supplied their declaration of competing interest.


2004 ◽  
Vol 171 (4S) ◽  
pp. 15-16
Author(s):  
Tatsuaki Yoneda ◽  
Shin Imai ◽  
Shinji Urakami ◽  
Hirofumi Kishi ◽  
Kazushi Shigeno ◽  
...  

Author(s):  
A. Babirad

Cerebrovascular diseases are a problem of the world today, and according to the forecast, the problem of the near future arises. The main risk factors for the development of ischemic disorders of the cerebral circulation include oblique and aging, arterial hypertension, smoking, diabetes mellitus and heart disease. An effective strategy for the prevention of cerebrovascular events is based on the implementation of large-scale risk control measures, including the use of antiagregant and anticoagulant therapy, invasive interventions such as atheromectomy, angioplasty and stenting. In this connection, the efforts of neurologists, cardiologists, angiosurgery, endocrinologists and other specialists are the basis for achieving an acceptable clinical outcome. A review of the SF-36 method for assessing the quality of life in patients with the effects of transient ischemic stroke is presented. The assessment of quality of life is recognized in world medical practice and research, an indicator that is also used to assess the quality of the health system and in general sociological research.


2020 ◽  
pp. 33-38
Author(s):  
E. Yu. Gan ◽  
L. P. Evstigneeva

Purpose of the study. Assessing the association between the life quality of patients with Sjogren’s Disease and ongoing therapy with various disease-modifying antirheumatic drugs.Material and methods. The study was conducted on the basis of the regional rheumatology center of the consultative diagnostic clinic of the Sverdlovsk Regional Clinical Hospital No. 1. This work is based on the results of a simultaneous study of 74 patients with primary Sjogren’s Disease (SD), distributed in three comparison groups receiving various disease-modifying antirheumatic drugs chlorambucil, methotrexate and hydroxychloroquine. The diagnosis of SD was carried out according to European-American criteria AECGC (2002) [18]. In order to analyze the quality of life of patients with SD, the 36-Item Short Form Health Survey (SF‑36) was used. Statistical data processing was carried out using Statistica 7.0 program.Results. Assessment of the quality of life of patients with SD, which is an integrative criterion of human health and well-being, revealed the absence of statistically significant differences (p > 0.05) on eight scales and two health components of the SF‑36 questionnaire in the analyzed groups that differ in the treatment of disease-modifying antirheumatic drugs chlorambucil, methotrexate and hydroxychloroquine.Conclusions. The obtained data indicate an equivalent quality of life in SD patients treated with different disease-modifying antirheumatic drugs methotrexate, chlorambucil and hydroxychloroquine, and therefore hydroxychloroquine can be considered as an alternative basic therapy in patients with SD with certain limitations and contraindications methotrexate and chlorambucil.


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