fibromyalgia and sexual problems

The aim of this review was to describe the recent literature concerning sexual dysfunction in fibromyalgic patients. To this end, we used the common online databases PubMed, MEDLINE and EMBASE (up to June 2012) and searched for the key words fibromyalgia (FM) and sexual dysfunction. All the studies examined underlined that FM is strictly associated with sexual dysfunction in women. The major findings observed were related to a decreased sexual desire and arousal, decreased experience of orgasm, and in some studies an increase in genital pain. The psychological aspects, together with the stress related to the constant presence of chronic widespread pain, fatigue and sleep disturbances, are certainly a major factor that adversely affects the sexuality of the patient with FM. Moreover, the drugs most commonly used in these cases may interfere negatively on the sexuality and sexual function of these patients. Therefore, the therapeutic intervention should be targeted and the side effects should be weighed up against the positive effects. It is of the utmost importance to recognise the problem of sexuality and sexual dysfunction in a more complex form of its expression and undertake a multidisciplinary therapeutic intervention to improve the quality of FM patients' life

Aderenza allo screening per il cancro della cervice uterina in una coorte italiana di donne affette da LES [Adherence to cervical cancer screening in an Italian SLE cohort]

OBJECTIVE: Papanicolau (Pap) smear abnormalities are more frequently observed in systemic lupus erythematosus (SLE) respect to the general population. The primary objective of the present study was to evaluate the adherence to cervical cancer (CC) screening in an Italian cohort of SLE patients and, secondly, to evaluate the disease-related factors possibly influencing the patients' behavior. METHODS: Consecutive 25 to 64 year old SLE patients and aged- matched healthy women were enrolled for the study. All patients were interviewed during ambulatory visits, at admission to the clinic or by a telephone contact; disease related variables were also collected from the clinical charts. RESULTS: 140 SLE patients (mean age 48.3±12 years) and 70 controls matched for demographic and sociocultural characteristics were enrolled. Ninety-three SLE patients (66.4%) declared to perform the Pap test at least every three years (23.6% yearly and 42.8% when asked by the screening programs) while 47 (33.6%) did not perform regular CC screening (16.4% never did the test and 17.1% only occasionally). No significant differences were observed between patients and controls in cancer screening adherence. No significant associations were observed between the screening program behaviors and disease-related variables. CONCLUSIONS: Despite the growing evidence of an increased risk of CC in SLE, and regardless of the broad availability of screening programs and official recommendations, our results show insufficient CC surveillance among SLE patients and emphasize to rheumatologists and/or general practitioners the importance to discuss with patients this aspect during routine evaluations in order to encourage compliance to the recommended preventive measures

[Ultrasound lung comets: new echographic sign of lung interstitial fibrosis in systemic sclerosis].

Objective: Interstitial lung disease (ILD) and pulmonary arterial hypertension (PAH) are common complications of systemic sclerosis (SSc). Echocardiography evaluates PAH, and chest sonography detects even mild ILC as ultrasound lung comets (ULC), i.e. multiple comet-tails fanning out from the lung surface and originating from subpleural interlobular septa thickened by fibrosis. Aim: to assess ILaD and PAH by integrated cardiac and chest ultrasound in SSc. Methods: We enrolled 30 consecutive SSc patients (age= 54±13 years, 23 females) in the Rheumatology Clinic of Pisa University. In all, we assessed systolic pulmonary arterial pressure (SPAP), from maximal velocity of tricuspid regurgitation flow, and ULC score with chest sonography (summing the number of ULC from each scanning space of anterior and posterior right and left chest, from second to fifth intercostal space). All patients underwent plasma assay for anti-topoisomerase antibodies (anti-Scl70), and antiicentromere associated with development of pulmonary involvement. Twenty-eight patients also underwent high resolution computed tomography, HRCT (from 0= no fibrosis to 3= honey combing). Results: ULC number - but not SPAP - was correlated to HRCT fibrosis and presence Scl-70 antibodies. ULC number was similar in localized or diffuse forms (16±20 vs 21±19, p=ns) and was unrelated to SPAP (r=0.216, p=ns). Conclusions: Chest sonography assessment and ULC allow a complete, simple, radiation-free characterization of interstitial lung involvement in SSc - all in one setting and with the same instrument, same transducer and the same sonographer. In particular, ULC number is associated with HRCT evidence of lung fibrosis and presence of Scl-70 antibodies

Autosub Long Range 1500: A continuous 2000 km field trial

Long Range Autonomous Underwater Vehicles (LRAUVs) offer the potential to monitor the ocean at higher spatial and temporal resolutions compared to conventional ship-based techniques. The multi-week to multi-month endurance of LRAUVs enables them to operate independently of a support vessel, creating novel opportunities for ocean observation. The National Oceanography Centre’s Autosub Long Range is one of a small number of vehicles designed for a multi-month endurance. The latest iteration, Autosub Long Range 1500 (ALR1500), is a 1500 m depth-rated LRAUV developed for ocean science in coastal and shelf seas or in the epipelagic and meteorologic regions of the ocean. This paper presents the design of the ALR1500 and results from a five week continuous deployment from Plymouth, UK, to the continental shelf break and back again, a distance of approximately 2000km which consumed half of the installed energy. The LRAUV was unaccompanied throughout the mission and operated continuously beyond visual line of sight

Fibromyalgia: a critical digest of the recent literature

Fibromyalgia is a common syndrome characterised by widespread pain and a constellation of other symptoms and overlapping conditions that contribute to complicate the diagnosis, the assessment and the treatment. Furthermore, the etiological causes for the moment only consist of assumptions, and the underlying pathogenetic mechanisms still remain to be clarified. For the above-mentioned reasons, with the present review we sought to provide an overview of the literature on fibromyalgia from both the pre-clinical and clinical studies indexed in PubMed during the last year, classifying original articles and reviews into etiopathogenesis, assessment and therapy

development of a functional disability measurement tool to assess early arthritis; the Recent-Onset Arthritis Disability (ROAD)

OBJECTIVE: To develop a self-administered questionnaire, the ROAD (Recent-Onset Arthritis Disability), to probe physical disability in Italian patients with early arthritis (EA) of less than one year's duration. METHODS: The development of the ROAD follows a series of major steps: (1) identification of a specific patient population, (2) item pool development, (3) item reduction, (4) internal consistency, (5) pre-testing of the prototype instrument, and (6) a validation study which results in determination, reliability, validity and responsiveness. In this study we have verified the first five steps. Pre-defined areas of disability were culled from eight existing Italian version arthritis-specific questionnaires, and three generic global health measurement tools. Semi-structured interviews helped to derive a 76-item pool from an initial group of 122 items. This questionnaire was administered to 78 EA patients. RESULTS: For scale generation, a combination of frequency importance product (FIP = frequency x mean relevance score) and factor analysis was applied. The top 20 items based on the FIP were then subjected to further analysis. Each question was correlated with every other question. This allowed us to eliminate 8 questions that were therefore highly correlated and were measuring the same concept. The final instrument has 12 items, representing a combination of symptoms that are common, frequently recurring and of general importance to EA patients. Factor analysis provides a 3-factor health status model explaining 70.1% of the variance. The upper extremity function (5 items) is loaded on the first factor, which explains 45.4% of the total measured variance. The lower extremity function (4 items) formed the second factor (14.2% of the total variance). The third factor was determined by activities of daily living/work (3 items) and explain 10.5% of the total variance. The score of the different subscales can be presented graphically as a ROAD profile. CONCLUSION: Using a traditional development strategy, we have constructed a self-administered instrument for measuring physical functioning in patients with EA. The next stage includes reliability, validity and responsiveness testing of the 12-item questionnaire

Periodontitis in Italian patients with established rheumatoid arthritis: A cross-sectional study

Objective: To assess the prevalence and severity of periodontitis (P) among Italian patients affected by rheumatoid arthritis (RA). Materials and methods: A full-mouth periodontal examination and a rheumatologic examination were performed. RA disease activity was scored using the DAS28. Serum analyses investigated levels of rheumatoid factor, anti-citrullinated protein antibodies (ACPAs), C-reactive protein, erythrocyte sedimentation rate and fibrinogen. Information concerning smoking, body mass index and RA medical therapy was collected. Data were analysed by Student's t test, chi-square test, binary logistic regression and Spearman's rank. Results: This cross-sectional study included 120 subjects, 77 had both diseases while 43 only had RA. The number of teeth present was statistically lower in the RA-P compared to the RA group (p <.05). There were statistically more subjects seropositive for ACPAs in the RA-P group (62.3% vs. 32.6%, p <.05). RA-P patients had an adjusted OR = 2.9 of presenting a moderate-severe DAS28 score (DAS28 ≥ 3.2). Conclusions: Higher prevalence of severe P was noted among RA subjects. The clinical severity of RA was strongly correlated with the clinical periodontal parameters, and RA subjects also affected by P had an OR of 2.9 for presenting with a moderate-severe RA (DAS28 score ≥ 3.2)

One year in review 2016 : fibromyalgia

Fibromyalgia (FM) syndrome is a chronic disease with unknown aetiology, characterised by widespread pain, fatigue and other functional symptoms. We reviewed the literature of the past year to underline the recent progress in the etiopathogenesis, assessment and therapies of this syndrome, evaluating the articles published between January 2015 and January 2016