29 research outputs found
Prevalence of irritable bowel syndrome in patients with fibromyalgia
INTRODUCTION: Fibromyalgia is a prevalent syndrome of widespread pain and multiple tender points, with no inflammatory, dystrophic or degenerative changes, probably related to abnormal central modulation of pain processing. Irritable bowel syndrome is considered a dysfunctional syndrome of visceral pain and/or alteration on gastrointestinal motility, also related to the same central nervous system (CNS) abnormalities. OBJECTIVE: The aim of this study was to evaluate the prevalence of irritable bowel syndrome in patients with fibromyalgia and to establish their clinical characteristics. PATIENTS AND METHODS:Two hundred consecutive patients with fibromyalgia syndrome were studied. RESULTS: These, 134 (67%) had irritable bowel syndrome. The most common presentation was the constipation subtype (121 =90.2%). The majority of patients had high scores of anxiety and/or depression. Conclusion: No differences were noted among patients with fibromyalgia without irritable bowel syndrome, and those with both conditions.INTRODUÇÃO: a sÃndrome da fibromialgia (FM) é uma sÃndrome dolorosa crônica comum na população em geral. Não apresenta qualquer processo inflamatório, distrófico ou degenerativo, e é considerada como conseqüente a disfunções neurofisiológicas envolvendo, principalmente, o sistema nervoso central (SNC). A sÃndrome do cólon irritável (SCI) é considerada como uma entidade disfuncional visceral, caracterizada por fenômenos motores do trânsito gastrointestinal, possivelmente relacionados a alterações neurofisiológicas nas mesmas vias do SNC. OBJETIVO: estudar a prevalência da SCI em portadores de FM e verificar as suas caracterÃsticas clÃnicas. PACIENTES E MÉTODOS: foram estudados 200 portadores da sÃndrome da FM. RESULTADOS: verificou-se que, entre esses pacientes, 134 (67%) apresentaram, concomitantemente, a SCI; entre esses, a maioria (121 = 90,2%) sofria o subtipo constipativo da moléstia. Traço de personalidade e estado emocional associados à ansiedade e depressão foram evidenciados numa substancial proporção desses pacientes. CONCLUSÃO: entre os pacientes com FM, não houve diferenças clÃnicas entre aqueles com e sem a SCI.Universidade Federal de São Paulo (UNIFESP)UNIFESPSciEL
Assessing knowledge on fibromyalgia among internet users
OBJECTIVE: To assess knowledge on fibromyalgia in a sample of patients, their families, and professionals interested on the theme from some Brazilian states. METHODS: Analysis of the results of an electronic fibromyalgia knowledge questionnaire completed by 362 adults who had access to the the support group for fibromyalgia site (www.unifesp.br/grupos/fibromialgia). The answers were grouped according to age, sex, years of schooling, and type of interest in the condition. RESULTS: 92% of the responders were women and 62% had higher educational level. The worst results were observed in the joint protection and energy conservation domain, followed by the medication in fibromyalgia domain. The best results were recorded in the exercises in fibromyalgia domain. The answers differed significantly between sexes, and women achieved a higher percentage of correct answers. The female sex accounted for a statistically superior result in five statistical analyses (four questions and one domain). CONCLUSIONS: The study suggests the need for a strategic planning for an educational approach to fibromyalgia in BrazilOBJETIVO: Analisar o nÃvel de conhecimento sobre fibromialgia em uma amostra incluindo pacientes, familiares e profissionais de vários estados do Brasil. MÉTODOS: Análise dos resultados de 362 adultos que acessaram o site do Grupo de Apoio à Fibromialgia (www.unifesp.br/grupos/fibromialgia) e responderam a um questionário eletrônico de conhecimento sobre a sÃndrome. As respostas foram avaliadas em relação a idade, sexo, nÃvel de escolaridade e tipo de interesse no Grupo. RESULTADOS: 92% eram mulheres e 62% haviam completado o ensino superior. O pior resultado foi no domÃnio proteção articular e conservação de energia, seguido pelo domÃnio conhecimento sobre medicação. O melhor resultado ocorreu no domÃnio exercÃcios para fibromialgia. Houve diferença significativa entre os gêneros, sendo as mulheres responsáveis por um porcentual maior de acertos. O gênero feminino foi responsável por um resultado estatisticamente superior em cinco análises estatÃsticas (quatro perguntas e um domÃnio). CONCLUSÕES: O estudo sugere a necessidade de um planejamento estratégico para ações educativas sobre fibromialgia no BrasilUNIFESP Centro Cochrane do BrasilUniversidade Federal do ABCUNIFESPCentro CochraneUNIFESP, Centro Cochrane do BrasilUNIFESPSciEL
Assessment of different instruments used as outcome measures in patients with fibromyalgia
OBJECTIVE: To assess the different measure instruments used for patients with fibromyalgia. PATIENTS AND METHODS: This study assessed 60 individuals participating in a clinical trial of cross-sectional cohort comparing the effects of exercises performed in water and on land. The following instruments were used: the Fibromyalgia Impact Questionnaire (FIQ) to assess the impact of the disease; the Medical Outcomes Study 36-item Short-Form Health Survey (SF-36) to assess quality of life; the Beck Depression Inventory to assess depression; and the Visual Analogue Scale (VAS) of pain. Those questionnaires were compared with the results obtained in a transitional Likert-type scale, the verbal scale for assessing change (VSAC), considered as a criterion of change in the assessment of other instruments. RESULTS: The Spearman coefficient was used to study the correlation between the VSAC measure and the other instruments at two occasions (T1 and T2). At T1, a moderate correlation was observed between VSAC and VAS (r = 0.49), and between VSAC and FIQ (r = 0.41), and a negative correlation was observed between VSAC and the SF-36 domains pain (r = -0.49) and general health perception (r = -0.55), and the SF-36 physical component (r = -0.42). At T2, only the SF-36 domain vitality showed a weak negative correlation with VSAC (r = -0.27). CONCLUSION: Considering VSAC as gold standard, none of the instruments assessed could optimally identify a change in the health status of patients with fibromyalgia.OBJETIVO: Avaliar os diferentes instrumentos de medida usados em pacientes com fibromialgia. PACIENTES E MÉTODOS: Foram avaliados 60 indivÃduos que participaram de um ensaio clÃnico de corte transversal comparando os efeitos de exercÃcios realizados na água e exercÃcios realizados em solo, por meio dos questionários Fibromyalgia Impact Questionnaire (FIQ) para avaliar o impacto da doença, The Medical Outcomes Study 36 item Short-Form Health Survey (SF-36) para avaliação da qualidade de vida, Inventário Beck para avaliar o estado de depressão e escala visual analógica da dor (EVA). Esses questionários foram comparados aos resultados obtidos em uma escala transicional do tipo Likert, a Escala verbal de avaliação de mudança (EVAM), considerada como critério de mudança na avaliação dos outros instrumentos. RESULTADOS: O coeficiente de Spearman foi usado para estudar a correlação entre a medida EVAM e os outros instrumentos em dois momentos (T1 e T2). Em T1 houve correlação moderada entre EVAM e EVA (r = 0,49), EVAM e FIQ (r = 0,41) e correlação negativa entre EVAM e os domÃnios referentes a dor (r = -0,49), estado geral (r = -0,55) e componente fÃsico (r = -0,42) do SF-36. Em T2, apenas o domÃnio vitalidade do SF-36 mostrou correlação negativa com EVAM, de valor fraco (r = -0,27). CONCLUSÃO: Considerando-se a EVAM como padrão ouro, nenhum dos instrumentos avaliados conseguiu captar, de maneira ótima, mudança no estado de saúde do paciente com fibromialgia.Universidade Federal de São Paulo (UNIFESP) Escola Paulista de MedicinaFaculdade de Medicina de MarÃliaUNIFESP, EPMSciEL
Effects of physical exercise on serum levels of serotonin and its metabolite in fibromyalgia: a randomized pilot study
To evaluate the effects of aerobic training and stretching on serum levels of serotonin (5HT) and its main metabolite 5-hydroxindolacetic acid (5HIAA). Twenty-two women with FM were randomized into one of two exercise modalities (aerobic walking exercise or stretching exercise) to be accomplished three times a week for 20 weeks. The serum levels of 5HT and 5HIAA were evaluated before and after the exercise program by high performance liquid chromatography (HPLC) with colorimetric detection. Within group analysis (pre-post) showed that serum levels of both 5HT and 5HIAA changed signifi cantly in the aerobic group during the 20-week course of therapy (5HT: P = 0,03; 5HIAA: P = 0,003). In the stretching group, however, no statistically signifi cant change was observed (5HT: P=0,491; 5HIAA: P=0,549). Between group statistical comparisons of laboratory measures disclosed that aerobic training was superior to stretching in that it signifi - cantly increased the levels of 5HIAA (F test = 6.61; P = 0.01), but the average difference between groups on the levels of 5HT did not meet signifi cance criteria (F test = 3.42; P = 0.08). Aerobic training increases the 5HIAA and 5HT levels and it could explain why aerobic exercise can improve symptoms in fi bromyalgia syndrome patient more than stretching exerciseAvaliar os efeitos do treinamento aeróbico e do alongamento sobre os nÃveis séricos de serotonina (5-HT) e seu principal metabólito ácido 5-hidroxiindolacético (5-HIAA). Foram randomizadas 22 mulheres com fibromialgia (FM) em uma de duas modalidades de exercÃcio (exercÃcio aeróbico de caminhada ou exercÃcio de alongamento) a serem realizadas três vezes por semana, por 20 semanas. Os nÃveis séricos de 5-HT e 5-HIAA foram avaliados antes e após o programa de exercÃcios por cromatografia lÃquida de alta eficiência (CLAE) com detecção colorimétrica. A análise de grupo (pré-pós) mostrou que os nÃveis séricos de 5-HT e 5-HIAA mudaram significativamente no grupo aeróbico durante o perÃodo de 20 semanas de terapia (5-HT: p = 0,03; 5-HIAA: p = 0,003). No grupo alongamento, contudo, não foi observada qualquer alteração estatisticamente significativa (5-HT: p = 0,491; 5-HIAA: p = 0,549). Comparações estatÃsticas das medidas de laboratório entre os grupos constataram que o treinamento aeróbico foi superior ao alongamento, aumentando significativamente os nÃveis de 5-HIAA (teste F - 6,61; p = 0,01); porém, a diferença média entre os grupos a respeito dos nÃveis de 5-HT não atendeu aos critérios de relevância (teste F = 3,42; p = 0,08). O treinamento aeróbico aumenta os nÃveis de 5-HIAA e 5-HT e poderia explicar porque o exercÃcio aeróbico pode melhorar os sintomas de pacientes com sÃndrome de fibromialgia mais que o exercÃcio de alongamento.Universidade Federal do EspÃrito Santo Departamento de ReumatologiaUniversidade Federal de São Paulo (UNIFESP)University of Texas Health Science Center at San AntonioUFES Departamento de DermatologiaUFES Departamento de EstatÃsticaUNIFESPSciEL
Latitude gradient influences the age of onset of rheumatoid arthritis : a worldwide survey
The age of onset of rheumatoid arthritis (RA) is an important outcome predictor. Northern countries report an age of RA onset of around 50 years, but apparently, variability exists across different geographical regions. The objective of the present study is to assess whether the age of onset of RA varies across latitudes worldwide. In a proof-of-concept cross-sectional worldwide survey, rheumatologists from preselected cities interviewed 20 consecutive RA patients regarding the date of RA onset (RAO, when the patient first noted a swollen joint). Other studied variables included location of each city, rheumatologist settings, latitudes (10A degrees increments, south to north), longitudes (three regions), intracountry consistency, and countries' Inequality-adjusted Human Development Index (IHDI). Data from 2481 patients (82% females) were obtained from 126 rheumatologists in 77 cities of 41 countries. Worldwide mean age of RAO was 44 +/- 14 years (95% CI 44-45). In 28% of patients, RA began before age 36 years and before age 46 years in 50% of patients. RAO was 8 years earlier around the Tropic of Cancer when compared with northern latitudes (p <0.001, 95% CI 3.5-13). Multivariate analysis showed that females, western cities, and latitudes around the Tropic of Cancer are associated with younger age of RAO (R (2) 0.045, p <0.001). A positive correlation was found between the age of RAO and IHDI (r = 0.7, p <0.01, R (2) 0.5). RA often begins at an early age and onset varies across latitudes worldwide. We postulate that countries' developmental status and their geographical and geomagnetic location influence the age of RAO.Peer reviewe
Estudo da evolução e prognóstico na dermatopolimiosite
BV UNIFESP: Teses e dissertaçõe
An evaluation of the association between fibromyalgia and repetitive strain injuries in metalworkers of an industry in Guarulhos, Brazil
Repetitive strain injuries are a common diagnostic label far musculoskeletal pain occurring at the workplace. Although many individuals present with diffuse pain, the diagnosis of fibromyalgia in this setting is rare. Our objective was to establish the paint prevalence of the fibromyalgia syndrome in a population of assembly line workers in São Paulo, Brazil. Methods. Thirty-four workers with repetitive strain injury diagnoses were studied and compared with 49 workers, paired by age, sex, and labor function. All individuals were studied by a comprehensive clinical protocol, Diagnosis of fibromyalgia syndrome was established when the 1990 American College of Rheumatology criteria far this syndrome were met. Results, Among the 34 workers with the diagnosis of repetitive strain injuries, 58.8% fulfilled the American College of Rheumatology criteria for fibromyalgia syndrome, while only 10.4% of the controls met the same criteria. Conclusions. Fibromyalgia syndrome was largely involved in the symptoms of patients with repetitive strain injuries, as opposed to coworkers with non-repetitive strain injuries, So, instead of the repetitive strain injuries label, many of these cases should be called fibromyalgic patients. (C) 2001 Editions scientifiques et medicates Elsevier SAS.UNIFESP, EPM, Div Rheumatol, BR-04023900 São Paulo, BrazilUNIFESP, EPM, Div Rheumatol, BR-04023900 São Paulo, BrazilWeb of Scienc