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Query: UMLS:C0016053 (fibromyalgia)
 4,687 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Twenty-three women with a diagnosis of breast cancer who subsequently developed new nonmetastatic rheumatic symptoms, and/or had a history of rheumatic symptoms prior to their diagnosis of breast cancer, were identified from the oncology and rheumatology practices of a 400-bed tertiary-care teaching hospital. For each patient a structured telephone interview and detailed chart review were conducted. Of eight women with no previous rheumatic history (Group I), four developed polyarthritis (1 seropositive), three fibromyalgia, and one spondylosis after the diagnosis of breast cancer, which in four cases occurred during or shortly after cyclophosphamide-based combination chemotherapy, in two cases during tamoxifen therapy, and in one case after radiotherapy only. Of 15 women who had previous rheumatic symptoms (Group II), 12 developed worse and/or new symptoms, five after chemotherapy and seven on tamoxifen. In both groups the symptoms had a significant negative impact on functional status, and in some cases resolution was only partial even after many years of followup. Prospective studies are needed to determine the incidence, risk factors, and optimal management of nondestructive polyarthropathy or fibromyalgia in women who receive systemic adjuvant therapy for breast cancer.
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PMID:Rheumatic symptoms following adjuvant therapy for breast cancer. 916 64

To investigate the risks of connective tissue diseases (CTDs) following breast implants we used the nationwide Danish Hospital Discharge Register (HDR) to identify 2,570 women who received breast implants, either for cosmetic reasons (N = 1,135) or for breast reconstruction (N = 1,435), between 1977 and 1992. Two additional cohorts of women having either breast reduction surgery (N = 7,071) or breast cancer without implants (N = 3,952) were identified for comparison. Observed-to-expected (O/E) cases of CTDs and other rheumatic conditions were calculated based on national hospital discharge rates. The calculated O/E ratio for definite CTDs was 1.1 (95% confidence interval [CI], 0.2-3.4) among women with cosmetic breast implants, and 1.3 (95% CI, 0.5-2.6) among women receiving implants for breast reconstruction. No CTD excesses were seen in the breast reduction or breast-cancer-without-implant cohorts. Statistically significant risks for muscular rheumatism (a nonspecific discharge diagnosis) were observed in all four patient cohorts: cosmetic (O/E ratio, 2.5; 95% CI, 1.7-3.6), breast reconstruction (O/E ratio, 2.5; 95% CI, 1.7-3.4), breast reduction (O/E ratio, 2.0; 95% CI, 1.6-2.3), and breast cancer without implants (O/E ratio, 1.4; 95% CI, 1.0-1.9). In conclusion, breast implants showed little association with definite CTDs. Breast surgery per so, however, was associated with an apparent increase in muscular rheumatism.
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PMID:Connective tissue disease and other rheumatic conditions following breast implants in Denmark. 946 8

Female sexual dysfunction (FSD) is a multifactorial set of conditions associated with multiple anatomical, physiological, biological, medical and psychological factors that can have major impact on self-esteem, quality of life, mood and relationships. Studies indicate that FSD is commonly seen in women who report a low level of satisfaction with partner relationship and in women with male partners who have erectile dysfunction. This complexity of FSD is augmented by the presence of chronic disease. Negative sexual effects are widely reported in studies of women with chronic diseases (such as metabolic syndrome, diabetes mellitus, chronic kidney disease, cancer, spinal cord injury, lupus, rheumatic diseases, Parkinson's disease, fibromyalgia and chronic pain) as compared to a general healthy female population. Physical problems, emotional problems and partnership difficulties arising from disease-related stress contribute to less active and less enjoyable sex life. Chronic pain, fatigue, low self-esteem as well as use of medications might reduce sexual function. These effects of chronic diseases on female sexual function still remain largely unstudied. The study by Manor and Zohar published in this issue of Harefuah draws our attention to the sexual dysfunction of women with breast cancer and examines their needs for information regarding their sexual function. In the absence of definite treatment evidence, psychological counseling, improved vaginal lubrication, low dose of hormonal therapy can be used to relieve FSD. Physicians must consider integrating diagnosis of their female patients' sexual needs and dysfunction, especially women with chronic diseases. Patients' education and counseling may contribute to a better quality of life in spite of their chronic disease.
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PMID:[Female sexual function and chronic disease]. 1650 15

Sleep difficulty is one of the hallmarks of menopause. Following recent studies showing no cardiac benefit and increased breast cancer, the question of indications for hormonal therapy has become even more pertinent. Three sets of sleep disorders are associated with menopause: insomnia/depression, sleep disordered breathing and fibromyalgia. The primary predictor of disturbed sleep architecture is the presence of vasomotor symptoms. This subset of women has lower sleep efficiency and more sleep complaints. The same group is at higher risk of insomnia and depression. The "domino theory" of sleep disruption leading to insomnia followed by depression has the most scientific support. Estrogen itself may also have an antidepressant as well as a direct sleep effect. Treatment of insomnia in responsive individuals may be a major remaining indication for hormone therapy. Sleep disordered breathing (SDB) increases markedly at menopause for reasons that include both weight gain and unclear hormonal mechanisms. Due to the general under-recognition of SDB, health care providers should not assume sleep complaints are due to vasomotor related insomnia/depression without considering SDB. Fibromyalgia has gender, age and probably hormonal associations. Sleep complaints are almost universal in FM. There are associated polysomnogram (PSG) findings. FM patients have increased central nervous system levels of the nociceptive neuropeptide substance P (SP) and lower serotonin levels resulting in a lower pain threshold to normal stimuli. High SP and low serotonin have significant potential to affect sleep and mood. Treatment of sleep itself seems to improve, if not resolve FM. Menopausal sleep disruption can exacerbate other pre-existing sleep disorders including RLS and circadian disorders.
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PMID:Menopause related sleep disorders. 1756 92

Deficits in cognitive function may impact one's ability to attend to stimuli, think clearly, reason, and remember. Impaired cognitive function is a common complaint among older women presenting for treatment in both mental health and medical care settings, and differential diagnosis of type and extent of cognitive impairment is important for appropriate treatment planning and prognosis. Although overall gender differences in prevalence of cognitive dysfunction are minimal, it is important when treating older women to take into account unique challenges they face in the aging process that impact the cause, type and extent of cognitive complaints with which they present in clinical settings. The current paper provides an overview to guide accurate diagnosis, particularly in women, of different types of cognitive impairment under the broad category of dementias, including Alzheimer's, Lewy Body Disease, Vascular Dementia, and due to general medical conditions such as coronary artery bypass surgery, head injury, menopause, hypothyroidism, breast cancer treatment, Fibromyalgia, and chronic fatigue. In addition, emotional factors such as depression in older female patients complicate differential diagnosis of cognitive impairment and must be addressed. Given the multiplicity of causes of cognitive difficulties for women across the life span, careful assessment is crucial; the current paper reviews assessment strategies to prepare an integrated, biopsychosocial strategy for identifying particular cognitive deficits and related psychological and medical problems. In addition, prognostic indicators and treatment planning are discussed to help the practitioner organize an empathic, reasoned and multifaceted treatment approach to maximize recovery, minimize deterioration, and manage symptoms for older women in the context of their social support system and living environment.
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PMID:Cognitive functioning and aging in women. 1758 77

The aim of this study was to explore the percentage of Dutch patients using the Internet to search for information about their illness. In addition, we studied patients' usage of health-related Internet applications, such as online patient support groups. The final objective of this study was to explore which demographic, health and psychological characteristics are related to patients' health-related Internet use. In order to answer these research questions we sent a written questionnaire to a representative sample of patients with breast cancer, rheumatoid arthritis and fibromyalgia. The overall total response rate was 69% (N = 679). In total, 52% of the patients used the Internet to search for information about their illness. However, only 15% of the respondents had ever read along with an online patient support group. An even smaller proportion of the patients (4%) had send postings to such a group. Online communication with health professionals was not commonly practiced. A younger age, a higher education and employment appeared to be the only significant predictors of patients' health-related Internet use. Patients' health-related Internet use could not be predicted by health and psychological characteristics. Although, about half of the patients made use of the Internet for health-related reasons, mostly their health-related Internet use was restricted to seeking information about their illness.
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PMID:Health-related Internet use by patients with somatic diseases: frequency of use and characteristics of users. 1930 96

We studied the success and success factors of online support groups (OSGs) for patients, and the motives and goals of people who start such groups. We interviewed 23 webmasters of OSGs for patients with breast cancer, fibromyalgia and arthritis. The majority were women (n = 20) and most were patients (n = 21). Analysis of the interviews revealed that webmasters had altruistic and intrinsic motives for initiating an online support group. They defined success as the fulfilment of the goals they had in mind when they initiated their groups. To be able to make a group successful, decisions about its organization and management need to be coherent with these goals. Most webmasters stressed that promoting the group, keeping it alive and moderating the messages were vital success factors during the evolution stage. Management of the OSGs took up much of the webmasters' time and energy. On average webmasters were occupied with the group for 10-15 hours a week. Our study provides an overview of the pros and cons of differing decisions that have to be made when initiating an OSG.
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PMID:Patient-initiated online support groups: motives for initiation, extent of success and success factors. 2008 65

A double-blind placebo-controlled randomized phase II trial was performed to determine whether High Dose Vitamin D2 supplementation (HDD) in women receiving adjuvant anastrozole improves aromatase inhibitor-induced musculoskeletal symptoms (AIMSS) and bone loss. Patients with early breast cancer and AIMSS were stratified according to their baseline 25-hydroxy vitamin D (25OHD) level. Stratum A (20-29 ng/ml) received either HDD 50,000 IU capsules weekly for 8 weeks then monthly for 4 months or placebo. Stratum B (10-19 ng/ml) received either HDD for 16 weeks and then monthly for 2 months, or placebo. AIMSS was assessed by the Brief Pain Inventory-Short Form (BPI-SF), the Fibromyalgia Impact Questionnaire (FIQ), and the Health Assessment Questionnaire-Disability Index (HAQ-DI) at baseline, 2, 4, and 6 months. Bone Mineral Density (BMD) was measured at baseline and at 6 months. The primary endpoint of the study was the change-from-baseline musculoskeletal pain. The secondary endpoint was the percent change in BMD at 6 months. Sixty women were enrolled. Baseline characteristics were comparable between the groups. At 2 months, FIQ pain (P = 0.0045), BPI worst-pain (P = 0.04), BPI average-pain (P = 0.0067), BPI pain-severity (P = 0.04), and BPI interference (P = 0.034) scores were better in the HDD than placebo group. The positive effect of HDD on AIMSS was stronger across all time points in Stratum B than Stratum A (FIQ pain, P = 0.04; BPI average, P = 0.03; BPI severity, P = 0.03; BPI interference, P = 0.04). BMD at the femoral neck decreased in the placebo and did not change in the HDD group (P = 0.06). Weekly HDD improves AIMSS and may have a positive effect on bone health. Vitamin D supplementation strategies for breast cancer patients on AI should be further investigated.
Breast Cancer Res Treat 2011 Aug
PMID:Vitamin D and aromatase inhibitor-induced musculoskeletal symptoms (AIMSS): a phase II, double-blind, placebo-controlled, randomized trial. 2169 17

Cancer patients often complain about weakness, fatigue, and pain. The aim of this study was to assess the features of the fibromyalgia syndrome (FMS) characteristics in patients with non-metastatic breast cancer. The study group included 40 women whose age ranged from 40 to 70 years with Stages 0-3 breast cancer. The control group included 40 healthy women matched by age. A diagnosis of FMS was established based on medical history, physical examination, and the Fibromyalgia Impact Questionnaire (FIQ). Pain measures and functional factors were evaluated by the Brief Pain Inventory and the Sheehan Questionnaire. Resilience was assessed by Antanovsky's Sense of Coherence Questionnaire. Psychiatric disturbances were tested by the MINI Questionnaire and Hamilton questionnaires for depression and anxiety. The prevalence of chronic pain was higher in the study group. Statistically significant differences were also found between the group regarding pain, fatigue, and functional measures. The prevalence of depressive or anxious mood, measured by the Hamilton questionnaires, was strongly related to FMS characteristics reflected by FIQ scores (r = 0.79 between FIQ and the Hamilton Depression Index and r = 0.75 between FIQ and the Hamilton Anxiety Scale). The sense of coherence measure for these patients demonstrated an inverse correlation with pain, fatigue, and functional capability. Women with breast cancer tend to develop chronic widespread pain syndromes more often than do healthy women.
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PMID:Association of fibromyalgia characteristics in patients with non-metastatic breast cancer and the protective role of resilience. 2190 52

We propose a biochemical mechanism for celiac disease and non-celiac gluten sensitivity that may rationalize many of the extradigestive disorders not explained by the current immunogenetic model. Our hypothesis is based on the homology between the 33-mer gliadin peptide and a component of the NMDA glutamate receptor ion channel - the human GRINA protein - using BLASTP software. Based on this homology the 33-mer may act as a natural antagonist interfering with the normal interactions of GRINA and its partners. The theory is supported by numerous independent data from the literature, and provides a mechanistic link with otherwise unrelated disorders, such as cleft lip and palate, thyroid dysfunction, restless legs syndrome, depression, ataxia, hearing loss, fibromyalgia, dermatitis herpetiformis, schizophrenia, toxoplasmosis, anemia, osteopenia, Fabry disease, Barret's adenocarcinoma, neuroblastoma, urinary incontinence, recurrent miscarriage, cardiac anomalies, reduced risk of breast cancer, stiff person syndrome, etc. The hypothesis also anticipates better animal models, and has the potential to open new avenues of research.
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PMID:Extraintestinal manifestations of celiac disease: 33-mer gliadin binding to glutamate receptor GRINA as a new explanation. 2699 Feb 86


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