scholarly journals Fibromyalgia Syndrome and Spa Therapy: Myth or Reality?

2012 ◽  
Vol 5 ◽  
pp. CMAMD.S8797 ◽  
Author(s):  
Giacomo M. Guidelli ◽  
Sara Tenti ◽  
Emanuele De Nobili ◽  
Antonella Fioravanti
Keyword(s):  
Pharmacological Treatment ◽  
Sleep Disturbances ◽  
Fibromyalgia Syndrome ◽  
Negative Impact ◽  
Modern Medicine ◽  
Chronic Widespread Pain ◽  
Treatment Modalities ◽  
Unknown Etiology ◽  
Spa Therapy ◽  
Clinical Effects

Fibromyalgia syndrome (FS) is a common musculoskeletal disorder characterized by otherwise unexplained chronic widespread pain, a lowered pain threshold, high tender point counts, sleep disturbances, fatigue, headache, irritable bowel syndrome, morning stiffness, paraesthesias in the extremities, often psychological distress and depressed mood. Consequently, FS has a negative impact on working capacity, family life, social functioning and quality of life. Because of unknown etiology and not clearly understood pathogenesis, there is no standard therapy regime for FS. A variety of medical treatments, including antidepressants, opioids, analgesic or non-steroidal anti-inflammatory drugs, sedatives, muscle relaxants and antiepileptics, have been used to treat FS. Currently, no pharmacological treatment for FS is consistently successful. According to recent guidelines, the optimal treatment of FS requires a multidisciplinary approach with a combination of non-pharmacological and pharmacological treatment modalities. Spa therapy is a popular treatment for FS in many European countries, as well as in Japan and Israel. However, despite their long history and popularity spa treatments are still the subject of debate and their role in modern medicine is still not clear. The objective of this review is to summarize the currently available information on clinical effects and mechanism of action of spa therapy in FS. We also provide some suggestions for further development in this area.

scholarly journals Clinical profile of patients with fibromyalgia syndrome

2017 ◽  
Vol 30 (2) ◽  
pp. 287-296 ◽  
Author(s):  
Andrei Pereira Pernambuco ◽  
Lorena Rodrigues Terra da Silva ◽  
Angélica Cristina Souza Fonseca ◽  
Débora d’Ávila Reis
Keyword(s):  
Sleep Disturbances ◽  
Fibromyalgia Syndrome ◽  
Clinical Decision Making ◽  
Pittsburgh Sleep Quality Index ◽  
Clinical Decision ◽  
Chronic Widespread Pain ◽  
The Other ◽  
Anxiety And Depression ◽  
Healthy Controls ◽  
Significance Level

Abstract Introduction: The new diagnostic criteria for fibromyalgia (FM) include the presence of chronic, widespread pain associated with other symptoms such as fatigue, sleep disturbance, anxiety and depression. All these symptoms should be considered when thinking and clinical decision making of physiotherapists dealing with FM. However, it is clear that the other symptoms that accompany the pain are often neglected. Objective: To measure the levels of fatigue, sleep disturbances, anxiety and depression in patients with FM and compare them to levels found in healthy controls. Methods: Forty-six women diagnosed with FM and 30 healthy controls participated in the study. The levels of each of the symptoms were assessed by four validated questionnaires in Brazil (Piper Fatigue Scale - Revised, Pittsburgh Sleep Quality Index, Beck Anxiety Inventory and the Beck Depression Inventory). Statistical analysis was performed using GraphPad Prism software and all tests used a significance level of 5% (α = 0.05). Results: FM patients had significantly elevated levels of fatigue (p = 0.0005), sleep disturbances (p = 0.003), anxiety (p = 0.0012) and depression (p = 0.0003) compared to healthy controls. Symptoms fatigue and depression correlated strongly and positively with one another and with other symptoms evaluated. Conclusion: The other symptoms that comprise the clinical picture of FM need be considered not only in order to recover the health of patients, but above all in an attempt to preserve it and promote it.

Investigation of ACE rs4646994, MTHFR rs1801133 and VDR rs2228570 Genotypes in Jordanian Patients with Fibromyalgia Syndrome

2020 ◽  
Vol 21 ◽  
Author(s):  
Raida Khalil ◽  
Wajdy J. Al-Awaida ◽  
Hamzeh J. Al-Ameer ◽  
Yazun Jarrar ◽  
Amer Imraish ◽  
...  
Keyword(s):  
Sleep Disturbances ◽  
Fibromyalgia Syndrome ◽  
Methylenetetrahydrofolate Reductase ◽  
Pain Tolerance ◽  
The Body ◽  
Restless Leg Syndrome ◽  
Jordanian Arabic ◽  
Clinical Investigations ◽  
Polymerase Chain ◽  
Larger Sample

Background: Fibromyalgia syndrome (FMS) is a chronic disease characterized by widespread body pain, weakness in certain parts of the body (critical points), low pain tolerance, sleep disturbances, and fatigue. This syndrome is considered rare in Jordan. Objectives: The research aimed to find out the association of the angiotensin converting enzyme, methylenetetrahydrofolate reductase, and vitamin D receptor (ACE, MHFTR, and VDR, respectively) genotypes with FMS among Jordanian patients. Methods: This work included 22 FM patients and 22 healthy individuals of Jordanian Arabic origin. The ACE rs4646994, MTHFR rs1801133, and VDR rs2228570 genotypes were determined using polymerase chain reaction (PCR) followed by restriction fragment length polymorphism. Results: No associations between ACE rs4646994, MTHFR rs1801133, and VDR rs2228570 with the vulnerability of a person for the development of FMS were found. However, we found an association between the ACE rs4646994 genotype and restless leg among FM patients. Conclusion: Based on result from this study, it appears that the ACE rs4646994 genotype is associated with restless leg among FMS patients of Jordanian origin. Further clinical investigations with larger sample sizes are required to confirm these findings and to understand the molecular mechanism of ACE rs4646994 genetic variant in the restless leg syndrome among FM patients.

scholarly journals Current Understanding of Novel Coronavirus: Molecular Pathogenesis, Diagnosis, and Treatment Approaches

Immuno ◽  
2021 ◽  
Vol 1 (1) ◽  
pp. 30-66
Author(s):  
Niraj Kumar Jha ◽  
Madhan Jeyaraman ◽  
Mahesh Rachamalla ◽  
Shreesh Ojha ◽  
Kamal Dua ◽  
...  
Keyword(s):  
Paradigm Shift ◽  
Functional Outcomes ◽  
Cellular Therapy ◽  
Treatment Modalities ◽  
Unknown Etiology ◽  
Huge Number ◽  
The World ◽  
To Come ◽  
Novel Coronavirus ◽  
Nano Medicine

An outbreak of “Pneumonia of Unknown Etiology” occurred in Wuhan, China, in late December 2019. Later, the agent factor was identified and coined as SARS-CoV-2, and the disease was named coronavirus disease 2019 (COVID-19). In a shorter period, this newly emergent infection brought the world to a standstill. On 11 March 2020, the WHO declared COVID-19 as a pandemic. Researchers across the globe have joined their hands to investigate SARS-CoV-2 in terms of pathogenicity, transmissibility, and deduce therapeutics to subjugate this infection. The researchers and scholars practicing different arts of medicine are on an extensive quest to come up with safer ways to curb the pathological implications of this viral infection. A huge number of clinical trials are underway from the branch of allopathy and naturopathy. Besides, a paradigm shift on cellular therapy and nano-medicine protocols has to be optimized for better clinical and functional outcomes of COVID-19-affected individuals. This article unveils a comprehensive review of the pathogenesis mode of spread, and various treatment modalities to combat COVID-19 disease.

scholarly journals Animal Models of Autosomal Recessive Parkinsonism

Biomedicines ◽  
2021 ◽  
Vol 9 (7) ◽  
pp. 812
Author(s):  
Guendalina Bastioli ◽  
Maria Regoni ◽  
Federico Cazzaniga ◽  
Chiara Maria Giulia De Luca ◽  
Edoardo Bistaffa ◽  
...  
Keyword(s):  
Animal Models ◽  
Sleep Disturbances ◽  
Autosomal Recessive ◽  
Clinical Manifestations ◽  
Cognitive Disorders ◽  
Dopamine Neurons ◽  
Substantia Nigra Pars Compacta ◽  
Current Status ◽  
Unknown Etiology ◽  
Neuron Death

Parkinson’s disease (PD) is the most common neurodegenerative movement disorder. The neuropathological hallmark of the disease is the loss of dopamine neurons of the substantia nigra pars compacta. The clinical manifestations of PD are bradykinesia, rigidity, resting tremors and postural instability. PD patients often display non-motor symptoms such as depression, anxiety, weakness, sleep disturbances and cognitive disorders. Although, in 90% of cases, PD has a sporadic onset of unknown etiology, highly penetrant rare genetic mutations in many genes have been linked with typical familial PD. Understanding the mechanisms behind the DA neuron death in these Mendelian forms may help to illuminate the pathogenesis of DA neuron degeneration in the more common forms of PD. A key step in the identification of the molecular pathways underlying DA neuron death, and in the development of therapeutic strategies, is the creation and characterization of animal models that faithfully recapitulate the human disease. In this review, we outline the current status of PD modeling using mouse, rat and non-mammalian models, focusing on animal models for autosomal recessive PD.

scholarly journals POS0998 SPONDYLOARTHRITIS AND SLEEP DISORDERS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 767.2-768
Author(s):  
S. Lahrichi ◽  
K. Nassar ◽  
S. Janani
Keyword(s):  
Functional Impairment ◽  
Sleep Disturbances ◽  
Negative Impact ◽  
University Hospital ◽  
Quality Of Sleep ◽  
The Mean ◽  
Sleep Deficit ◽  
Impaired Sleep ◽  
The Impact

Background:Spondyloarthropathies (SpA) are a group of chronic and progressive diseases, characterized in particular by a progressive stiffening of the spine, spreading to neighboring joints or to certain tissues, which could lead in the long term to progressive stiffening and functional impairment. This conditioncancauseinsomnia problems and impaired sleep quality.Objectives:To assess the impact of SpA on the quality of sleep.Methods:This is a retrospective study over a period of 4 years from January 2015 to December 2019, including all the medical records of patients with SpA followed in the Department of Rheumatology of the University Hospital of Ibn Rochd, Casablanca. We evaluated for each patient two validated scores: the Epworth somnolence scale rated from 0 to 24, and the Pittsburgh sleep score rated from 0 to 21 with 7 components. Patients with a psychiatric history or who were followed up for neurological pathologies were excluded.Results:178 patients were included. 60.67% were men with an average age of 36.32 years (14-68 years). 45.01% had axial SpA, 29.77% had psoriatic arthritis, and 25.22% were followed for SpA associated with inflammatory bowel disease. 45% had associated comorbidities: there were 18 diabetics and 34 hypertensive, 16.58% were smokers. Clinically, 85.42% presented a back pain initially on examination, 55% presented a polyarthralgia, and 39.88% an oligoarthritis. 63% had radiological sacroiliitis, and 35.14% had bilateral coxitis. 13.48% had a positive HLA B27 and 58.89% had a positive inflammatory assessment with very high activity indices,with a mean of 4.6. 64.66% of the patients received NSAIDs,of which 11% responded well. 57% were treated with csDMARDs, and 17.86% were treated with biologics. At the time of our study, the mean visual analog scale was 5.84 ± 1.7 out of 10 (2-9). The mean Epworth score was 8.38 ± 5.2 (0-21). 56.1% of patients had no sleep debt, 33.3% had a sleep deficit, and only 10.6% had signs of drowsiness. For the overall Pittsburgh score, the mean was 7.02 ± 3.6 (1-18). The mean of “subjective quality of sleep” was 1.12, “sleep latency” was 1.22, “duration of sleep” was 1.06, “usual sleep efficiency” was 0.74, “Sleep disturbance” of 1.28, “use of a sleep medication” of 0.54, and the average of the component concerning “poor shape during the day” was 1.03 out of 3. The LEQUESNE index went from an average of 6 to 8, which corresponds to an average handicap (P = 0.2) over a period of 3 years. 68% of the patients had an alteration in the quality of sleep, starting on average three years after the onset of symptoms. 11% reported having experiencedanxiety and depressive symptoms, and reported having used antidepressants or anxiolytics in the past 5 years.Conclusion:Our study showed the negative impact of SpA on the duration and overall quality of sleep. The degree of pain as well as functional impairment can cause and worsen sleep disturbances in SpA. We have shown that the Pittsburg score increases significantly with the increase of pain.The Lequesne score and that the Epworth score increase with disease activity[1].References:[1]StolwijkC,vanTubergenA,Castillo-OrtizJD,BoonenA.Prevalenceofextra-articularmanifestationsinpatientswithankylosingspondylitis:asystematicreviewandmeta-analysis.AnnRheumDis2015;74:65—73.Disclosure of Interests:None declared.

scholarly journals Demographic, psychological, chronobiological, and work-related predictors of sleep disturbances during the COVID-19 lockdown in Italy

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Federico Salfi ◽  
Marco Lauriola ◽  
Aurora D’Atri ◽  
Giulia Amicucci ◽  
Lorenzo Viselli ◽  
...  
Keyword(s):  
Sleep Disturbances ◽  
Negative Impact ◽  
Female Gender ◽  
Protective Role ◽  
Depression Symptoms ◽  
Work Related ◽  
Working From Home ◽  
Delayed Sleep Phase ◽  
Delayed Sleep ◽  
Morning Type

AbstractThe first COVID-19 contagion wave caused unprecedented restraining measures worldwide. In Italy, a period of generalized lockdown involving home confinement of the entire population was imposed for almost two months (9 March–3 May 2020). The present is the most extensive investigation aimed to unravel the demographic, psychological, chronobiological, and work-related predictors of sleep disturbances throughout the pandemic emergency. A total of 13,989 Italians completed a web-based survey during the confinement period (25 March–3 May). We collected demographic and lockdown-related work changes information, and we evaluated sleep quality, insomnia and depression symptoms, chronotype, perceived stress, and anxiety using validated questionnaires. The majority of the respondents reported a negative impact of confinement on their sleep and a delayed sleep phase. We highlighted an alarming prevalence of sleep disturbances during the lockdown. Main predictors of sleep disturbances identified by regression models were: female gender, advanced age, being a healthcare worker, living in southern Italy, confinement duration, and a higher level of depression, stress, and anxiety. The evening chronotype emerged as a vulnerability factor, while morning-type individuals showed a lower predisposition to sleep and psychological problems. Finally, working from home was associated with less severe sleep disturbances. Besides confirming the role of specific demographic and psychological factors in developing sleep disorders during the COVID-19 pandemic, we propose that circadian typologies could react differently to a particular period of reduced social jetlag. Moreover, our results suggest that working from home could play a protective role against the development of sleep disturbances during the current pandemic emergency.

Challenges in the Management of Ruptured and Unruptured Brainstem Arteriovenous Malformations: Outcome After Conservative, Single-Modality, or Multimodality Treatments

Neurosurgery ◽  
2011 ◽  
Vol 70 (1) ◽  
pp. 155-161 ◽  
Author(s):  
Laurent Thines ◽  
Amir R. Dehdashti ◽  
Leodante da Costa ◽  
Michael Tymianski ◽  
Karel G. ter Brugge ◽  
...  
Keyword(s):  
Scale Score ◽  
Odds Ratio ◽  
Arteriovenous Malformations ◽  
Negative Impact ◽  
Multimodality Treatment ◽  
Treatment Modalities ◽  
Modified Rankin Scale ◽  
Mortality And Morbidity ◽  
Cure Rates ◽  
Single Modality

Abstract BACKGROUND Brainstem arteriovenous malformations are challenging lesions, and benefits of treatment are uncertain. OBJECTIVE To study the clinical course of Brainstem arteriovenous malformations and the influence of treatments on outcome. METHODS We reviewed a prospective series of 31 brainstem arteriovenous malformations. Demographic, morphological, and clinical characteristics were recorded. Factors determining initial and final outcomes (modified Rankin Scale), results of treatments (cure rates, complications), and disease course were analyzed. RESULTS Brainstem arteriovenous malformations were symptomatic and bled in 93% and 61% of cases, respectively. Examination was abnormal and initial modified Rankin Scale score was > 3 in 71% and 86% of patients, respectively. The average follow-up time was 6.2 years, and 26% of patients rebled (5.9 %/y). Treatment modalities included conservative, radiosurgical, endovascular, surgical, and multimodality treatment in 13%, 58%, 35%, 16%, and 26% of cases, respectively. The obliteration rate was 60% overall and 39% after radiosurgery, 40% after embolization, and 75% after microsurgery, with respective complication-free cure rates of 71%, 50%, and 0%. Overall procedural mortality and morbidity were 2.3% and 18.6%, respectively. Final modified Rankin Scale score was > 3 in 77% of cases. Neurological deterioration (35%) was related to treatment complications in 74% of cases with a negative impact of surgery (P = .04), palliative embolization (odds ratio = 16), and multimodality treatments (odds ratio = 24). Radiosurgery was inversely associated with worsening (odds ratio = 0.06). CONCLUSION Brainstem arteriovenous malformations require individualized treatment decisions. Single-modality treatments with a reasonable chance of complete cure and low complication rate (such as radiosurgery) should be favored.

scholarly journals Clinical effects of nonpharmacological treatment of ADHD

2021 ◽  
Author(s):  
Matheus Almeida Ribeiro da Cunha ◽  
João Gustavo dos Anjos Morais Oliveira ◽  
Gabriela Sarno Brandão ◽  
Ana Flávia Paiva Bandeira Assis ◽  
Leonardo Mattos Santos ◽  
...  
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Attention Deficit ◽  
Pharmacological Treatment ◽  
Methodological Quality ◽  
Pharmacological Therapy ◽  
Pharmacological Intervention ◽  
Clinical Effects ◽  
Nonpharmacological Treatment ◽  
Hyperactivity Disorder ◽  
School Of Medicine

Background: Though pharmacotherapy of Attention Deficit Hyperactivity Disorder (ADHD) is widespread, some patients suffer with side effects or do not improve with it. Objectives: Evaluate clinical outcomes of non-pharmacological therapy on ADHD. Design and Setting: This is a literature review, produced in Bahiana School of Medicine and Public Health. Methods: Articles published between 2011 and 2021 were taken from PubMed, using the following search: (“Non-pharmacological treatment” OR “Non- pharmacological therapy” OR “Non-pharmacological intervention” OR “Non-drug treatment” OR “Non-drug therapy” OR “Adjuvant treatment” OR “Adjuvant therapy”) AND (“ADHD” OR “Attention Deficit-Hyperactivity Disorder”). Studies that did not match this review’s objectives were excluded. Results: 20 of the 57 articles found, were selected. Reviews that approach treatment in general indicate non-pharmacological therapy specially when there are obstacles to use of drugs, but highlight the lack of studies with methodological quality in this field. Clinical studies indicate reduction of symptoms through neurofeedback, transcranial magnetic stimulation, and aerobic exercises. One of the interventions with the most articles was nutritional supplementation, though most of them did not find significant improvement. Conclusions: Non-pharmacological treatment of ADHD is a relevant alternative, especially when there is no response to medication, but studies with better methodological quality are necessary.

scholarly journals Rheumatoid arthritis activity scores in patients with and without fibromyalgia syndrome

2021 ◽  
Vol 41 (4) ◽  
pp. 246-252
Author(s):  
Yunus Durmaz ◽  
Ilker Ilhanli
Keyword(s):  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Fibromyalgia Syndrome ◽  
Conflicts Of Interest ◽  
Systemic Disease ◽  
Response To Treatment ◽  
Unknown Etiology ◽  
Tender Joint Count ◽  
Tender Joint ◽  
Cross Sectional

BACKGROUND: Fibromyalgia syndrome (FM) is a systemic disease of unknown etiology, which can cause widespread musculoskeletal pain. In patients with rheumatoid arthritis (RA), FM can cause an additional symptom burden, which can affect some variables on the RA disease activity score 28 (DAS28), a tool that evaluates 28 joints in RA patients. OBJECTIVE: Compare the results of four different versions of the DAS28 and the parameters used to determine disease activity scores in RA patients with and without FM, and determine whether there are treatment differences between RA patients with and without FM. DESIGN: Retrospective, cross-sectional. SETTING: Tertiary hospital. PATIENTS AND METHODS: We identified patients diagnosed with RA between 1 September 2016 and 1 February 2020 and identified patients with and without FM. MAIN OUTCOME MEASURES: Differences between variables in the DAS28 calculations (tender joint count [TJC], patient global assessment [PGA], and others), between patients with and without FM, and differences between patients with and without FM who were using or not using biological agents. SAMPLE SIZE: 381, including 322 females (84.5%). RESULTS: The frequency of FM in RA patients was 25.7% (89 females, 24.6%). In RA patients with FM, the TJC and PGA median values were significantly higher than in patients without FM ( P <.05). The use of corticosteroids and biological therapy in patients with FM was more frequent than in patients without FM ( P <.05). Compared to patients without FM, patients with FM switched treatment more often because of non-response to treatment ( P =.01) Median values of the DAS28 scores (calculated by four different versions of the instrument) in RA patients with FM were higher than in patients without FM ( P <.05). CONCLUSION: The presence of FM in RA patients may affect the subjective variables in different versions of DAS28 scores, causing the disease activity to score higher on the instrument, erroneously indicating worse disease than is actually present. LIMITATIONS: A single center, retrospective study. CONFLICTS OF INTEREST: None.

scholarly journals Effect of COVID-19 Lockdown on Patients with Multiple Sclerosis: an Italian Survey

2021 ◽  
pp. 1-7
Author(s):  
Marta Altieri ◽  
◽  
Mariangela Fratino ◽  
Flavia Pauri ◽  
Antonella Conte ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Family Caregiving ◽  
Social Life ◽  
Negative Impact ◽  
Self Report ◽  
Psychological Status ◽  
Control Group ◽  
Clinical Effects ◽  
Future Expectations ◽  
The Impact

Background: Italy was one of the first affected countries by coronavirus disease 2019 (COVID-19) pandemic. Public health measures like quarantine or national lockdown were adopted, with negative psychological and clinical effects on patients with chronic diseases. To investigate the impact of lockdown on patients with multiple sclerosis (MS), we developed a 36 items self-report questionnaire. Methods: Questionnaires were emailed to 120 patients with MS and 100 with chronic migraine (CM) as a control group, matched for age, sex, and education. The questionnaire was divided into five domains, evaluating concerns about 1) MS and therapy during COVID-19 pandemic, 2) personal and family caregiving, 3) working activities, 4) general and disease-related emotions during the lockdown, 5) future expectations concerning health status, social life, and working activity. Results: patients with MS had higher scores than those with CM in domains 4 and 5, investigating respectively general and disease-related emotions and future expectations (p= 0.05 and 0.02 respectively). About half of the patients with MS expressed some concern about the need to continue their therapy during the pandemic compared to people with CM (p= 0.0002). Conclusions: Covid-19 pandemic had a more negative impact on psychological status of patients with MS compared with those with CM

Sign in / Sign up

Export Citation Format

Share Document