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

Non-steroidal antiinflammatory drugs are not very effective, even if commonly used, in primary fibromyalgia syndrome (PFS), whereas cyclobenzaprine (C) has proved to be quite useful. The aim of this open randomized study was to compare low-dose C alone or in combination with ibuprofen (I) in 32 female patients suffering from PFS. Fifteen patients were given C 10 mg, and 17 patients C 10 mg plus I 600 mg. All patients received the drugs orally at night and were evaluated at baseline and at days 5 and 10. Assessment of efficacy included the number of tender points (max. = 16), muscle tightness (score 1-5), sleep difficulty (score 1-10), pain intensity (visual analogue scale 0-10) and duration of morning stiffness (min). At the end of the study all symptoms were found to be improved to the same extent in both treatment groups. An exception was morning stiffness, which became significantly more reduced in the patients taking C plus I. No patient discontinued the trial owing to adverse side-effects. In conclusion, C and I given concomitantly at night proved to be safe and advantageous in relieving the discomfort of PFS in the short term.
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PMID:Combined therapy with cyclobenzaprine and ibuprofen in primary fibromyalgia syndrome. 142 4

In a controlled study, 40 patients with refractory fibromyalgia were randomly allocated to treatment with either hypnotherapy or physical therapy for 12 weeks with followup at 24 weeks. Compared with the patients in the physical therapy group, the patients in the hypnotherapy group showed a significantly better outcome with respect to their pain experience, fatigue on awakening, sleep pattern and global assessment at 12 and 24 weeks, but this was not reflected in an improvement of the total myalgic score measured by a dolorimeter. At baseline most patients in both groups had strong feelings of somatic and psychic discomfort as measured by the Hopkins Symptom Checklist. These feelings showed a significant decrease in patients treated by hypnotherapy compared with physical therapy, but they remained abnormally strong in many cases. We conclude hypnotherapy may be useful in relieving symptoms in patients with refractory fibromyalgia.
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PMID:Controlled trial of hypnotherapy in the treatment of refractory fibromyalgia. 202 2

A multidimensional evaluation of 78 patients with primary fibrositis/fibromyalgia syndrome (PFS) revealed no significant relationship between clinical measures of physical discomfort and psychological measures. This observation provided evidence against the notion that the pain of PFS has a psychological etiology. The same patients were randomized into 4 groups for treatment with ibuprofen and/or alprazolam in a randomized, double-blind, double-dummy, placebo-controlled pilot trial. Clinical improvement in patient rating of disease severity and in the severity of tenderness upon palpation was most apparent in the subgroup of patients who were receiving both ibuprofen and alprazolam. An 8-week, open-label study in which 52 patients received both drugs further documented improvement in outcome measures. These data indicate that treatment with a combination of ibuprofen and alprazolam can be beneficial for some patients with PFS.
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PMID:Treatment of primary fibrositis/fibromyalgia syndrome with ibuprofen and alprazolam. A double-blind, placebo-controlled study. 202 9

The purpose of this study is to describe the current treatment methods minorities use and believe are effective in relieving the pain and discomfort of arthritis. One hundred sixty subjects from two urban, low-income minority communities reported to case finders that they had some form of arthritis. Subsequently they were interviewed and examined by a rheumatologist. Sixty-six percent were black, and 34% were Hispanic. The study found that 83% had some type of rheumatic disease. Differences existed between the black and Hispanic samples in age, rheumatic disease distribution, and methods of care. The majority of black respondents were older, with a frequent diagnoses of osteoarthritis, compared to the Hispanics, who reported fibrositis as their dominant rheumatic problem. An array of conventional and nonconventional therapies were used by both groups to care for their arthritis. Prayer (92%), equipment (70%), and heat (33%) were reported as "most helpful" for the blacks. Hispanics reported prayer (50%), heat (40%), and topical ointments as "most helpful." In order to communicate and provide optimal care to patients from divergent cultural backgrounds, it is important to understand both likenesses and differences, and to be sensitive to the patient's belief system and health care practices.
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PMID:Methods used by urban, low-income minorities to care for their arthritis. 248 94

Patients with the fibrositis syndrome experience moderately severe musculoskeletal discomfort, mood changes associated with nonrestorative sleep, and tenderness to palpation at specific body sites. There is no characteristic abnormal laboratory finding in these patients to help identify the population. A report by Moldofsky and Warsh (Pain 1978; 5: 65-71) of low serum levels of free tryptophan in patients with severe fibrositis syndrome is intriguing but remains unexplained. Those data plus the observation by Hudson et al (Am J Psychiatry 1985; 142: 441-446; Biol Psychiatry 1984; 19: 1489-1493) that patients with fibrositis syndrome exhibit an increased prevalence of anxiety and depression suggest a number of possible avenues for further study. They include potential alterations in the homeostasis of catecholamines, corticosteroids, serotonin, aromatic amino acids, platelet membrane receptor levels, and the activity of platelet membrane monoamine oxidase. Among these possibilities, evidence is now available that suggests an increased production of catecholamines in fibrositis syndrome.
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PMID:Is there a metabolic basis for the fibrositis syndrome? 346 8

The pressure threshold meter (PTM) and its use for evaluation of tender spots and trigger points are described. Pressure threshold is the minimum pressure inducing pain or discomfort. The PTM consists of a force gauge (11 kg range) to which a rubber disc with lcm2 surface is attached. This surface has been proven adequate for quantification of deep tenderness in soft tissues. Normal threshold values were established in 50 volunteers, 24 men and 26 women, at nine different sites frequently affected by trigger points, including the trapezius, supraspinatus, infraspinatus, teres major, lumbar paraspinals (2 sites), gluteus and pectoralis muscles. The deltoid, where muscle sensitivity is usually normal, was used as a reference. PTM is used clinically for quantification of tenderness for medicolegal purposes, but primarily to prove the presence of trigger points to patients and health professionals. Reaction to various forms of treatment such as physiotherapy and drugs can be assessed quantitatively. When trigger point injections are properly administered to affected areas, pressure threshold measurements usually increase by 4 kg/cm2. Failure to increase the reading indicates that the injection was incomplete and the procedure should be repeated. The PTM can be used for monitoring tenderness, inflammation, arthritis activity, and fibrositis.
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PMID:Pressure threshold meter: its use for quantification of tender spots. 377 85

When evaluating the current status of a patient with diseases of the TMJ, certain guidelines must be followed. It is of the utmost importance to take into consideration the total picture. This must include the history, physical examination, x-rays, films, and any other pertinent information. As stated previously, the TMJ is demonstrated with a great deal of clarity by modern tomographic x-ray techniques. This, however, provides only part of the total evidence. It is indeed unfortunate that some medical and dental consultants for insurance companies and other health groups base their criteria for eligibility on the evidence provided only by the x-ray films, without taking into consideration other important data. Another source of error is the fact that the total duration of the patient's symptoms is not given enough consideration. This is shown in patients with a history lasting many months or years, associated with definite x-ray changes, who are misdiagnosed as having myofascial pain dysfunction syndrome. The fact that this is an acute process of short duration involving primarily muscles of mastication and other related soft tissues is overlooked. When presented with a patient with a long history of TMJ discomfort, it is essential to consider an intrinsic organic process of the joint. It should be stressed that osteoarthritis or degenerative joint disease is a condition frequently found in the TMJ when examined with modern tomographic techniques. It occurs in individuals of all ages. Osteoarthritis of the TMJ is basically a medical or orthopedic condition similar to that found in other joints of the body affected by this primary joint disease. For this reason, osteoarthritis cannot be considered purely a dental condition when it occurs in the TMJ. However, because of the close proximity, both anatomically and physiologically, to the teeth and related structures, these conditions are frequently labeled as dental.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Radiology of the temporomandibular joint. 657 65

A prospective neuro-otological study concerning 30 cases of fibrositis syndrome (psychogenic rheumatism, PR) and 30 age-matched normal controls was made and a retrospective study concerning 33 cases of Meniere's disease (MD) diagnosed and followed-up, examined between 1965 and 1982. Results showed: sensorineural hearing loss at low frequencies in all early stages of MD and in 10/30 of PR; hyperacusis (pain threshold below 100 dBHL bilaterally for all frequencies) without other sign of recruitment in 73.3% of PR and in 3/4 cases of MD where it was measured (discomfort or vertigo due to noise was noted retrospectively in 16/33 of early stages of MD); hyperreactivity of per-rotatory nystagmus in 53.3% of PR without neurological or peripheral vestibular lesions and, with or without vestibular unilateral lesions, in 39.9% of MD. None of the controls showed hyperacusis, hyperreactivity of per-rotatory nystagmus or deafness at low frequencies.
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PMID:Meniere's disease and fibrositis syndrome (psychogenic rheumatism). Relationship in audiometric and nystagmographic results. 659 16

Fibromyalgia is a common cause of pain, discomfort and disability. In this article, the author describes the symptoms and possible aetiology. The article also highlights how nurses can enhance patients' quality of life by helping them to cope with pain, establish sleep patterns, take exercise, manage stress, improve concentration and memory, and fight isolation.
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PMID:Fibromyalgia: what help can nurses give? 761 57

Fibromyalgia syndrome (FMS) is a common and costly cause of work disability. Patients with FMS, nevertheless, encounter considerable difficulties in their assessment of claims for disability payments. Factors that contribute to FMS as an important cause of disability are its high prevalence, the patients' perception of severe discomfort, and poor function. Disability evaluation in FMS is controversial for several reasons including lack of acceptance of the diagnosis, concurrent psychological abnormalities, difficulties in objectifying disability, deficiencies in instruments of evaluation, the uncertain efficacy of treatment, and physician attitudes. Third parties appear to have inappropriate expectations of the physician's role in determining disability. We suggest that the process of disability evaluation be improved by more objective assessments and by the inclusion of other health professionals in assessing disability and necessary retraining. Further research is needed to develop better instruments for measuring disability, to assess the long-term effects of various treatments, and to clarify the contributions of the work place and of compensation in causing or aggravating FMS.
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PMID:Work disability evaluation and the fibromyalgia syndrome. 766 42


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