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

This article reviews the common musculoskeletal disorders that are likely to be encountered in the women's primary care setting. Basic anatomy and physiology of the musculoskeletal system are reviewed, and the assessment and treatment of complaints of strains, sprains, low back pain, chest pain, carpal tunnel syndrome, musculoskeletal pain syndrome, fibromyalgia, osteoporosis, and osteoarthritis are discussed. Examples of low-technology treatment strategies are included.
 ...
PMID:Primary care for women. Comprehensive assessment of common musculoskeletal disorders. 777 20

An insufficient compliance is regularly observed in 30% of outpatients. In chronic rheumatic diseases such as rheumatoid arthritis a poor compliance is often associated with alleviation of symptoms whereas symptomatic patients tend to take their medication more regularly. Drug abuse, mainly corticosteroids, can often not be avoided. The latter may 'particularly in women' lead to osteoporosis with subsequent fractures. In patients with fibrositis compliance is often a poor because of digestive problems associated with NSAIDs and the bad response to drugs and adjuvant therapies.
 ...
PMID:[Compliance to therapy in daily practice--rheumatologic diseases]. 829 18

Osteoporosis is thought to represent one of the main causes of back pain in perimenopausal women. One hundred perimenopausal women (45 to 60 years) who were consecutively admitted in order to clarify the cause of their back pain were examined. In 20% disc degenerations were found. Other degenerative disorders (osteoarthritis) of the spine without coincident scoliosis were found to be the second most common cause of pain in 19%. Scoliosis due to different leg length was detected in 15%, idiopathic scoliosis in 13%. Spondylolisthesis occurred in 7% even more frequently than osteoporosis with vertebral deformities in 6%. Non-osteoporotic vertebral deformities were seen as often as osteoporotic ones. Rare diagnoses among others were seronegative spondyloarthropathy and fibrositis. Our results indicate that back pain in women up to 60 years is mostly due to degenerative disorders of the spine. Osteoporosis with vertebral deformities as cause of pain is quite rare. Comparing bone mineral density of the distal forearm (SPA) of the patients with back pain not due to manifest osteoporosis (98 +/- 15% of age related mean) with those of 50 asymptomatic women (96 +/- 14%) and 50 female patients with pain in other regions of the skeleton (103 +/- 17%) in the same age group, there was no evidence for any relation between low bone mineral density and skeletal pain.
 ...
PMID:[Backache and osteoporosis in perimenopausal women]. 843 32

In only 30% of back pain patients an underlying pathology can be found. Rheumatologic causes in a narrow sense are fibromyalgia, osteoporosis and the group of spondylathropathies and reactive arthritis. Infectious disorders of the spine are emergency cases and need immediate and interdisciplinary action. Careful evaluation of signs and symptoms indicate the suspected origin of pain and lead to the use of more specialized diagnostic means. Therapy of specific back pain should be appropriate to the clinical disorders. In acute, nonspecific back pain, the aim is to prevent a chronification of disease by instruction and education of the patient and an early start of physical therapy. The rehabilitation process in chronic cases in complex and may need psychobehavioral methods for pain control. Pharmacologic modalities of treatment-simple analgesics, nonsteroidal antirheumatic drugs, muscle relaxants and antidepressants-should only be used for a limited period and monitored constantly.
 ...
PMID:[Backache from the internal medicine-rheumatologic viewpoint]. 913 6

This article reviews common rheumatic diseases that most frequently occur in women including fibromyalgia, rheumatoid arthritis, Sjogren's syndrome, systemic lupus erythematosus and the antiphospholipid antibody syndrome. Many of these women are of child bearing potential and special considerations concerning pregnancy often arise. Rheumatic conditions that frequently affect older women such as osteoarthritis and polymyalgia rheumatica are discussed as well. Osteoporosis, which has emerged as a significant women's health issue, is also reviewed.
 ...
PMID:Rheumatologic disorders in women. 945 52

A MEDLINE search of the 1996 and 1997 literature yielded two reviews of the methodology of cost-effectiveness analyses (CEAs) in the field of rheumatology and eight original CEAs evaluating slow-acting antirheumatic agents (two studies), total hip arthroplasty for patients with osteoarthritis (one study), educational intervention for patients with fibromyalgia (one study), interventions for patients with low back pain (three studies), and hormone replacement therapy for women with osteoporosis (one study). Most CEAs relied on modelling of data that were assembled from various sources; however, in one CEA a cost-effectiveness comparison was based on data collected prospectively within a randomized clinical trial. Extensive sensitivity analyses were conducted by a majority of the studies. The CEAs of slow-acting antirheumatic agents provided results that were difficult to interpret given extensive modelling and reliance on expert estimates. Only one CEA was supported by an industry grant. Most of the studies were of high quality and met current methodologic requirements, including the use of discounting, sensitivity analysis, and incremental analysis. However, the major shortcoming of these recent studies continues to be the use of estimated costs instead of prospectively measured resource utilization data presented in terms of separate physical units.
 ...
PMID:A review of cost-effectiveness analyses in rheumatology and related disciplines. 956 9

To review the available evidence that has used generic instruments alone or in comparison with disease specific instruments. A systematic review was carried out using the methods recommended by the Cochrane Collaboration. We used MEDLINE and EMBASE searches and we performed a hand search of the abstracts listed under "quality of life" at American College of Rheumatology (ACR) meetings. Selection was limited to randomized controlled trials (RCT) using generic instruments in populations older than 18 years with any of the following diseases: rheumatoid arthritis, fibromyalgia, osteoporosis, osteoarthritis, systemic lupus erythematosus, and ankylosing spondylitis. Language was restricted to English papers. Studies using only disease-specific instruments were excluded. From 488 articles retrieved, 13 reports of 10 randomized controlled trials were selected. There were 101 abstracts on quality of life in ACR abstract books; 78 abstracts contained data on generic instruments, and of these, 9 described their use in RCT. Despite a substantial increase in the number of papers and abstracts addressing different aspects of generic questionnaires, the majority of the papers were descriptive. The evidence is not yet available to document that any of the generic instruments pass the requirements of the OMERACT Filter.
 ...
PMID:The responsiveness of generic quality of life instruments in rheumatic diseases. A systematic review of randomized controlled trials. 991 66

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.
 ...
PMID:Pain in nursing home residents: management strategies. 1123 36

Few medical professionals would dispute the obvious health benefits afforded by regular exercise if pursued judiciously and in moderation. Cardiovascular disease, hypertension, osteoporosis, diabetes, depression, and fibromyalgia are a few of the many disorders in which exercise plays a key role in management. Less well-appreciated until recently is the beneficial effect exercise may have in the treatment of osteoarthritis (OA). Previously, rest and inactivity seemed to be the prevailing treatment strategy until it was recognized that this approach was ineffective and contributed further to the patient's disability and loss of function. New trial data support the value of physical exercise whether it involves aerobic or resistance-type training. The studies are not without statistical and methodologic imperfections. Still, the evidence favoring an exercise intervention as part of the OA treatment plan is impressive. It remains for the clinician to select an appropriate exercise routine that meets the strength, balance, flexibility, and aerobic needs of the patient. The clinician then monitors and evaluates the patient's response to this activity with the same exactness used in following pharmacologic therapy.
 ...
PMID:Exercise in the treatment of osteoarthritis. 1170 15

The stress system coordinates the adaptive responses of the organism to stressors of any kind.(1). The main components of the stress system are the corticotropin-releasing hormone (CRH) and locus ceruleus-norepinephrine (LC/NE)-autonomic systems and their peripheral effectors, the pituitary-adrenal axis, and the limbs of the autonomic system. Activation of the stress system leads to behavioral and peripheral changes that improve the ability of the organism to adjust homeostasis and increase its chances for survival. The CRH and LC/NE systems stimulate arousal and attention, as well as the mesocorticolimbic dopaminergic system, which is involved in anticipatory and reward phenomena, and the hypothalamic beta-endorphin system, which suppresses pain sensation and, hence, increases analgesia. CRH inhibits appetite and activates thermogenesis via the catecholaminergic system. Also, reciprocal interactions exist between the amygdala and the hippocampus and the stress system, which stimulates these elements and is regulated by them. CRH plays an important role in inhibiting GnRH secretion during stress, while, via somatostatin, it also inhibits GH, TRH and TSH secretion, suppressing, thus, the reproductive, growth and thyroid functions. Interestingly, all three of these functions receive and depend on positive catecholaminergic input. The end-hormones of the hypothalamic-pituitary-adrenal (HPA) axis, glucocorticoids, on the other hand, have multiple roles. They simultaneously inhibit the CRH, LC/NE and beta-endorphin systems and stimulate the mesocorticolimbic dopaminergic system and the CRH peptidergic central nucleus of the amygdala. In addition, they directly inhibit pituitary gonadotropin, GH and TSH secretion, render the target tissues of sex steroids and growth factors resistant to these substances and suppress the 5' deiodinase, which converts the relatively inactive tetraiodothyronine (T(4)) to triiodothyronine (T(3)), contributing further to the suppression of reproductive, growth and thyroid functions. They also have direct as well as insulin-mediated effects on adipose tissue, ultimately promoting visceral adiposity, insulin resistance, dyslipidemia and hypertension (metabolic syndrome X) and direct effects on the bone, causing "low turnover" osteoporosis. Central CRH, via glucocorticoids and catecholamines, inhibits the inflammatory reaction, while directly secreted by peripheral nerves CRH stimulates local inflammation (immune CRH). CRH antagonists may be useful in human pathologic states, such as melancholic depression and chronic anxiety, associated with chronic hyperactivity of the stress system, along with predictable behavioral, neuroendocrine, metabolic and immune changes, based on the interrelations outlined above. Conversely, potentiators of CRH secretion/action may be useful to treat atypical depression, postpartum depression and the fibromyalgia/chronic fatigue syndromes, all characterized by low HPA axis and LC/NE activity, fatigue, depressive symptomatology, hyperalgesia and increased immune/inflammatory responses to stimuli.
 ...
PMID:Hypothalamic-pituitary-adrenal axis, neuroendocrine factors and stress. 1237 95


1 2 3 4 5 Next >>