Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0016053 (fibromyalgia)
 4,687 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Chronic intractable benign pain (CIBP) is defined as non-neoplastic pain of greater than 6 months duration without objective physical findings and known nociceptive peripheral input. To test the CIBP concept, 283 consecutive chronic pain patients were examined independently by a neurosurgeon and physiatrist and only congruent physical findings were coded. Because they did not fit the CIBP definition, patients with the following primary treatment diagnoses were eliminated: degenerative disease of the spine and spinal stenosis; degenerative disease of the hips; radiculopathy; malignancy; deafferentation pain; and miscellaneous. Eliminated, also, were patients with any one finding indicative of a root compression syndrome, leaving 90 low back and 34 neck patients. These patients had abnormal physical findings in 7 categories: tender points/trigger points; decreased ranges of motion in back or neck; non-anatomical sensory loss; rigid musculature; decreased range of hip motion; gait disturbance; and miscellaneous non-neurologic signs. Low back CIBP patients had the following distribution among the 7 categories: 0% had findings of all 7; 1.1% had 6; 13.3% had 5; 24.4% had 4; 25.6% had 3; 26.7% had 2; 8.9% had 1; and 0% had none. Neck CIBP patients, in which only the first 4 categories of physical findings were applicable had the following distribution: 2.9% had 4; 41.2% had 3; 35.3% had 2; 20.6% had 1; and 0% had none. It was concluded that CIBP patients do have abnormal physical findings indicative of musculoskeletal disease: possibly fibrositis and/or specific myofascial syndromes, as sources of peripheral nociception. These findings question the validity of the CIBP concept and point to the need for a careful, all-inclusive physical examination as a basic initial requirement in the classification of chronic pain patients.
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PMID:Physical findings in patients with chronic intractable benign pain of the neck and/or back. 263 5

Seventy-one patients with polymyositis-dermatomyositis (PM/DM) admitted to the Wellesley Hospital Rheumatic Disease Unit (RDU) in Toronto between 1965 and 1980 were followed up to 1981. The frequencies of malignant neoplasms occurring prior to or concurrent with initial RDU admission were compared, using case-control methods, with age- and sex-matched control groups with a diagnosis of any non-PM/DM rheumatic disease (rheumatic disease controls) or osteoarthritis, fibrositis, or fracture (noninflammatory musculoskeletal controls). In a cohort analysis, the incidence of malignant neoplasm subsequent to initial RDU admission in patients with PM/DM was compared with the expected incidence in the Canadian population. Fifteen of 71 patients with PM/DM had an antecedent or concurrent cancer compared with four of 71 rheumatic disease controls and one of 71 noninflammatory musculoskeletal controls. Cohort analysis showed no increase in the number of subsequent malignant neoplasms in patients with PM/DM compared with the age- and sex-matched Canadian population.
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PMID:The frequency of malignant neoplasms in patients with polymyositis-dermatomyositis. A controlled study. 387 87

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

The human body is exposed to a wide array of xenobiotics in one s lifetime, from food components to environmental toxins to pharmaceuticals, and has developed complex enzymatic mechanisms to detoxify these substances. These mechanisms exhibit significant individual variability, and are affected by environment, lifestyle, and genetic influences. The scientific literature suggests an association between impaired detoxification and certain diseases, including cancer, Parkinson's disease, fibromyalgia, and chronic fatigue/immune dysfunction syndrome. Data regarding these hepatic detoxification enzyme systems and the body s mechanisms of regulating them suggests the ability to efficiently detoxify and remove xenobiotics can affect these and other chronic disease processes. This article reviews the myriad detoxification enzyme systems, their regulatory mechanisms, and the dietary, lifestyle, and genetic factors influencing their activities, as well as laboratory tests available to assess their functioning.
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PMID:The detoxification enzyme systems. 963 Jul 36

Polymyalgia rheumatica (PMR) is a disease of unknown etiology characterized by severe myalgia and stiffness at shoulder girdle and pelvic girdle muscles and by normal serum creatine kinase levels. Marked elevation of erythrocyte sedimentation rate, acute onset within two weeks, and appearance in the aged are also additional characteristics of PMR. Ten to 50% of PMR patients have a concomitant temporal arteritis (TA)(giant cell arteritis). For the differential diagnoses of PMR, rheumatoid arthritis, polymyositis, fibromyalgia, malignancies, infections and depression should be considered. PMR without TA is treatable successfully with small amount of steroids (15-20 mg/day of prednisolone). For the PMR patients with TA should be treated with large amount of steroids (40-60 mg/day of prednisolone) or steroid pulse therapy.
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PMID:[Polymyalgia rheumatica]. 1007 7

Pain is prevalent and undertreated in nursing home residents, despite the existing wide array of effective pharmacological and nonpharmacological treatment modalities. In order to improve the quality of life of these vulnerable individuals, practitioners require education about the correct approach to assessment and management. Assessment should be comprehensive, taking into account the basic underlying pathology (e.g. osteoarthritis, osteoporosis, peripheral neuropathy, fibromyalgia, cancer) as well as other contributory pathology (e.g. muscle spasm, myofascial pain) and modifying comorbidities (e.g. depression, anxiety, fear, sleep disturbance). Pharmacological management should be guided by a stepped-care approach, modelled after that recommended by the World Health Organization for treatment of cancer pain. Nonopioid and opioid analgesics are the cornerstone of pharmacological pain management. Tricyclic antidepressants and anticonvulsants can be very effective for the treatment of certain types of neuropathic pain. In addition to treating the pain per se, attention should be given to prevention of disease progression and exacerbation, as maintaining function is of prime importance. Nursing home residents with severe dementia challenge the practitioner's pain assessment skills; an empirical approach to treatment may sometimes be warranted. The success of treatment should be measured by improvement in pain intensity as well as physical, psychosocial and cognitive function. Effective pain management may impact any or all of these functional domains and, therefore, substantially improve the nursing home resident's quality of life.
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PMID:Pain in nursing home residents: management strategies. 1123 36

The term fibromyalgia refers to a collection of symptoms with no clear physiologic cause, but the symptoms together constitute a clearly recognizable and distinct pathologic entity. The diagnosis is made through the examiner's clinical observations. The differential diagnosis must include other somatic syndromes as well as disease entities, including hepatitis, hypothyroidism, diabetes mellitus, electrolyte imbalance, multiple sclerosis, and cancer. Diagnostic criteria serve as guidelines for diagnosis, not as absolute requirements. Treatment of fibromyalgia, which is an ongoing process, remains individualized, relying on a good physician-patient relationship. It is goal-oriented, directed at helping patients get restorative sleep, alleviating the somatic pains, keeping patients productive, and regulating schedules. It can be achieved through a goal-oriented agreement between patient and provider. Because fibromyalgia is chronic and may affect all areas of an individual's functioning, the physician needs to also evaluate the social support systems of patients with fibromyalgia. The approach to treatment should integrate patient education as well as non-pharmacologic and pharmacologic modalities. To keep patients well educated and involved in their healthcare, physicians should provide patients with adequate sources for reliable information.
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PMID:A practical approach to fibromyalgia. 1139 5

Because the role of elemental sulfur in human nutrition has not been studied extensively, it is the purpose of this article to emphasize the importance of this element in humans and discuss the therapeutic applications of sulfur compounds in medicine. Sulfur is the sixth most abundant macromineral in breast milk and the third most abundant mineral based on percentage of total body weight. The sulfur-containing amino acids (SAAs) are methionine, cysteine, cystine, homocysteine, homocystine, and taurine. Dietary SAA analysis and protein supplementation may be indicated for vegan athletes, children, or patients with HIV, because of an increased risk for SAA deficiency in these groups. Methylsulfonylmethane (MSM), a volatile component in the sulfur cycle, is another source of sulfur found in the human diet. Increases in serum sulfate may explain some of the therapeutic effects of MSM, DMSO, and glucosamine sulfate. Organic sulfur, as SAAs, can be used to increase synthesis of S-adenosylmethionine (SAMe), glutathione (GSH), taurine, and N-acetylcysteine (NAC). MSM may be effective for the treatment of allergy, pain syndromes, athletic injuries, and bladder disorders. Other sulfur compounds such as SAMe, dimethylsulfoxide (DMSO), taurine, glucosamine or chondroitin sulfate, and reduced glutathione may also have clinical applications in the treatment of a number of conditions such as depression, fibromyalgia, arthritis, interstitial cystitis, athletic injuries, congestive heart failure, diabetes, cancer, and AIDS. Dosages, mechanisms of action, and rationales for use are discussed. The low toxicological profiles of these sulfur compounds, combined with promising therapeutic effects, warrant continued human clinical trails.
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PMID:Sulfur in human nutrition and applications in medicine. 1189 44

Pain is associated with myriad medical conditions and affects millions of Americans. Chronic pain is one of the most common reasons prompting visits to healthcare providers; collectively, it possibly disables more people annually than heart disease and cancer combined. Primary goals of treating patients with chronic pain are to reduce pain as much as possible and facilitate functional restoration. When chronic pain becomes a disease state, it can be controlled, but, at present, it cannot be cured. Better understanding of the pathophysiology of acute and chronic pain has led to numerous advances in pharmacologic management of painful disorders, including low back pain, migraine headache, fibromyalgia, postherpetic neuralgia, osteoarthritis, rheumatoid arthritis, and cancer-related neuropathic pain. This presentation reviews the available agents and how to use them rationally, either singly or in combination, so practitioners can treat patients with chronic pain as effectively as possible.
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PMID:Pharmacologic management of chronic pain. 1235 37

Four subjects living with profoundly debilitating and life-threatening illnesses reflect on how psychotherapy has contributed to their ability to cope and survive. With frankness and eloquence they address issues related to cancer, heart disease, fibromyalgia, and AIDS.
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PMID:Pushing through solid rock: words of wisdom for clinicians from four patients with life-threatening conditions. 1241 51


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