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

Lyme disease is a multisystem inflammatory disease caused by infection with Borrelia burgdorferi. Soon after the tick bite which transmits the infection, the pathognomonic skin rash erythema chronicum migrans occurs in 50 to 70% of patients, often with associated symptoms resembling a 'summer cold' or viral infection. Therapy for this stage of disease consists of 3 to 4 weeks of oral therapy. The agents currently used are: amoxicillin (500 mg 3 or 4 times daily) with or without probenecid 500 mg 3 times daily, doxycycline (100 mg twice daily), or tetracycline (500 mg 4 times daily). Longer duration therapy has never been evaluated and therefore is not currently indicated. Even patients with severe early manifestations of Lyme disease should be treated orally. Later features of Lyme disease include carditis and neurological disease, which can occur days to approximately 9 months after the onset of illness, and arthritis and neurological disease which can occur weeks to years after the onset of the illness. Treatment at this stage is with 2 to 3 weeks of intravenous antibiotics, currently cefotaxime (3 g every 12 hours), ceftriaxone (1 g every 12 hours or 2 g every day) and benzylpenicillin (14 g in divided doses). There is no evidence that longer duration therapy is indicated or more efficacious. The exception to this suggestion is the patient with isolated facial seventh cranial nerve palsy; if such a patient has no other signs or symptoms to suggest Lyme disease and has normal spinal fluid, oral therapy is usually sufficient, although some physicians will give concomitant corticosteroids to hasten the resolution of the palsy. Of major consequence to the practitioner and patient is the possibility that persistent symptoms (e.g. fibromyalgia) may be caused by a process which is no longer antibiotic-sensitive. Special care in the management of so-called 'chronic Lyme disease' is crucial lest the clinician prescribes prolonged or unending courses of antibiotics for such noninfectious problems.
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PMID:Current recommendations for the treatment of Lyme disease. 137 47

In a cross-over study, the short-term efficacy of whole-body cold therapy and hot mud packs in patients with generalized tendomyopathy (fibromyalgia) was compared. As a pain assessment, visual analog scale and so-called pain score were measured; dolorimetry of the 24 tender points and eight control points was performed as well. Using these methods, we found that there is a significant improvement of all parameters examined during a 2-h period of measurements after cold application, and a marked improvement was also detectable 24 h after this therapy. In contrast, only pain score values showed a slight decrease immediately after hot mud-pack therapy, and no significant differences were found in visual analog scale and pressure tenderness as measured dolorimetrically. Central inhibition of nociceptors as a result of an activation of A-delta system as well as a blockade of gamma-motoneurons are discussed to be a mechanism of action of whole-body cold therapy, resulting in a decrease in muscle tonus. Long-term studies are needed to determine, if there is any enduring effect of whole-body cold therapy on pain in the patients with generalized tendomyopathy.
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PMID:[Intraindividual comparison of whole body cold therapy and warm treatment with hot packs in generalized tendomyopathy]. 157 33

The peripheral sympathetic activity was studied in 27 patients with fibromyalgia and 29 healthy controls through simultaneous measurements of electrodermal variables and blood flow at palmar skin sites during baseline, acoustic stimulation, and cold pressor tests. Compared to the controls, the patient group showed a significantly larger overall increase in the skin electrical conductance and less vasoconstriction during acoustic stimulation and cold pressor tests. These findings imply an increased activity of cholinergic and decreased activity of adrenergic components of the peripheral sympathetic nervous system in patients with fibromyalgia.
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PMID:Electrodermal and microcirculatory activity in patients with fibromyalgia during baseline, acoustic stimulation and cold pressor tests. 175 41

Twenty-nine female patients with fibromyalgia were questioned about symptoms of cold intolerance and Raynaud's syndrome; objective documentation of cold-induced vasospasm was obtained by a Nielsen test. Twelve patients (41%) had abnormal Nielsen test results, and 11 patients (38%) had elevated levels of platelet alpha 2-adrenergic receptors. There was a positive correlation between the percentage of change in finger systolic pressure on cooling (Nielsen test) and the number of alpha 2-adrenergic receptors. There was poor correlation between Raynaud's syndrome symptoms and an abnormal Nielsen test result. Digital photoplethysmography showed a normal waveform in 2 of 3 patients. We hypothesize that a subgroup of patients with fibromyalgia syndrome have an up-regulation of alpha 2-adrenergic receptors as a cause of their exaggerated reaction to cold.
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PMID:Symptoms of Raynaud's syndrome in patients with fibromyalgia. A study utilizing the Nielsen test, digital photoplethysmography, and measurements of platelet alpha 2-adrenergic receptors. 184 29

The contention that muscles are the "end organs" responsible for fibromyalgia symptomatology is unproven. This review presents a contemporary synopsis of muscle physiology and then describes studies in the fibromyalgia syndrome which have yielded objective data of distorted muscle physiology and cold reactivity.
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PMID:Muscle physiology and cold reactivity in the fibromyalgia syndrome. 264 74

Twenty-seven female patients with fibromyalgia and 29 female healthy controls underwent an auditive stimulation test and a left hand cold pressor test at 10 and 4 degrees C. The microcirculatory changes observed, indicate that, as a response to 80 dB, 1000 Hz, 2 seconds sounds and cooling with associated pain, the vasoconstrictory responses are less in patients with fibromyalgia than in normal controls. This could indicate altered sympathetic nervous activity in patients with fibromyalgia and that the cutaneous manifestations previously interpreted as Raynaud's phenomenon should be reconsidered.
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PMID:Altered sympathetic nervous system response in patients with fibromyalgia (fibrositis syndrome). 268 47

Fibrositis is a misnomer for a very common form of nonarticular rheumatism. The name implies an inflammatory process in fibroconnective tissue which has never been verified. The symptoms of fibrositis are ill-defined musculoskeletal pain made worse by stress, cold, noise and unaccustomed exercise; there is usually a significant element of depression, nonrestorative sleep, chronic fatigue and early morning stiffness. Results of physical examination are strikingly normal, apart from painful tender spots which are remarkably consistent in location from patient to patient. It is important to realize that fibrositis can complicate diseases such as rheumatoid arthritis and systemic lupus erythematosus, where its prompt recognition is essential in averting inappropriate medication. Drug therapy alone is seldom effective in alleviating symptoms; a carefully planned education program is necessary to readjust both psyche and soma.
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PMID:Fibrositis: misnomer for a common rheumatic disorder. 616 73

Soft tissue rheumatism (extraarticular rheumatism) is a group of common disorders found separately as independent disorders or as a symptom of systemic joint or spine diseases. The most frequent soft tissue rheumatisms are tendinopathies, rheumatism of muscles with myofascial pains, fibrositis of subcutaneous tissue and, finally, bursitis and inflammations of tendon sheaths. The commonest therapeutic procedures are non-steroidal anatirheumatic drugs, local infiltrations of corticosteroids, and physiotherapy. In the acute stages cold packs are the best physical measure against subjective pain. In subacute and chronic cases the pain in subcutaneous tissues can be lessened by connective tissue massage and underwater jet massage, muscle pain by heat and active exercises, and tendinopathies by ultrasonics and electrotherapy but very seldom by heat. In chronic bursitis and tendovaginitis, iontophoresis with potassium iodine may be helpful. Reflex pains in muscles are due to lesions of the spine and should therefore be treated by spine extension and manipulations. Every pain in soft tissue has one source in the anatomic lesion of the tissue and the second in psychogenic disorders. The latter must be sought when soft tissue pains are found all over the body on the lines of a generalized fibrositis syndrome.
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PMID:[Physical therapy and rheumatism of soft tissues]. 698 13

Using capillary videomicroscopy of the nail fold, the frequency of cold-induced vasospasm and capillary hemodynamic parameters were studied after application of cold in 50 patients with primary fibromyalgia, 50 patients with chronic low back pain, and 50 healthy controls. Cold-induced vasospasm was detected in 38% of the patients with fibromyalgia. In this group it was significantly more frequent than in the patients with chronic low back pain (20%, p < 0.05) and healthy subjects (8%, p < 0.001). In the fibromyalgia group, the magnitude of vasospasm as measured by the capillary blood flow deceleration after cold application correlated negatively with the pain intensity as measured by pain score (r = -0.3839, p < 0.01). No differences in clinical appearance were found between patients with and without cold-induced vasospasm in both the fibromyalgia and low back pain group.
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PMID:Cold-induced vasospasm in patients with fibromyalgia and chronic low back pain in comparison to healthy subjects. 783 7

Experimental measures of responsiveness to painful and non-painful stimuli as well as measures of typical and present clinical pain were assessed in 26 female patients with fibromyalgia and in an equal number of age-matched healthy women. Pressure pain thresholds, determined by means of a dolorimeter, were lower in the patients compared to the control subjects both at a tender point (trapezius) and at a non-tender control point (inner forearm). The same was true for the heat pain thresholds, measured using a contact thermode. In contrast, the pain thresholds for electrocutaneous stimuli were decreased only at the tender point. The detection thresholds for non-painful stimuli (warmth, cold and electrical stimuli) seemed to be less affected in the fibromyalgia patients, with only the detection threshold for cold being lower at both sites. Tender points were more sensitive than control points for mechanical pressure. The reverse was found for the other modalities which were tested. Although the 3 experimental pain thresholds showed patterns of either generalized or site-specific pain hyperresponsiveness, the between-methods correlations were not very high. While the correlations between the experimental pain thresholds and the various measures of clinical pain (Localized Pain Rating, McGill Pain Questionnaire) in the patients were generally low, there were significant negative correlations between pressure pain thresholds at the two sites and the level of present pain assessed by the Localized Pain Rating. We conclude that a pattern of pain hyperresponsiveness, generalized across the site of noxious stimulation and across the physical nature of the stressor, is associated with fibromyalgia.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Multi-method assessment of experimental and clinical pain in patients with fibromyalgia. 785 1


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