Pain in systemic connective tissue diseases

Pain is frequent in patients with connective tissue diseases (CTDs), particularly those affected by systemic sclerosis (SSc) and systemic lupus erythematosus (SLE) in which it is virtually ubiquitous and can have different causes. The SLE classi fi cation criteria include pain associated with musculoskeletal involve- ment, which are frequently the initial symptom of SLE and can include arthralgia, arthritis and/or myalgia. Chronic widespread pain, the cornerstone of fi bromyalgia (FM), is also frequently associated with CTDs. Chronic pain has a considerable impact on mental health, and the professional and family lives of patients. It can be due to many disorders, but there are few reports concerning its prevalence during the course of other diseases. It is essential to identify the origin of pain in CTDs in order to avoid dangerous over-treatment in patients with co-existing widespread pain. Effective pain management is a primary goal of patient care, although it has not been investigated in detail in patients with SSc

Building bridges between doctors and patients: the design and pilot evaluation of a training session in argumentation for chronic pain experts

Shared decision-making requires doctors to be competent in exchanging views with patients to identify the appropriate course of action. In this paper we focus on the potential of a course in argumentation as a promising way to empower doctors in presenting their viewpoints and addressing those of patients. Argumentation is the communication process in which the speaker, through the use of reasons, aims to convince the interlocutor of the acceptability of a viewpoint. The value of argumentation skills for doctors has been addressed in the literature. Yet, there is no research on what a course on argumentation might look like. In this paper, we present the content and format of a training session in argumentation for doctors and discuss some insights gained from a pilot study that examined doctors' perceived strengths and limitations vis-à-vis this training

Biology and therapy of fibromyalgia. Genetic aspects of fibromyalgia syndrome

Genetic and environmental factors may play a role in the etiopathology of fibromyalgia syndrome (FMS) and other related syndromes. There is a high aggregation of FMS in families of FMS patients. The mode of inheritance is unknown but it is most probably polygenic. There is evidence that polymorphisms of genes in the serotoninergic, dopaminergic and catecholaminergic systems play a role in the etiology of FMS. These polymorphisms are not specific for FMS and are associated with other functional somatic disorders and depression. Future genetic studies in the field of FMS and related conditions should be conducted in larger cohorts of patients and ethnically matched control groups

The prevalence of fibromyalgia in the general population : A comparison of the American College of Rheumatology 1990, 2010 and modified 2010 classification criteria

Copyright © 2014 American College of Rheumatology. Funded by University of Aberdeen Development TrustPeer reviewedPostprin

Demandas e itinerarios en la agenda de democratización cordobesa : derechos humanos y movilización estudiantil en Córdoba, 1984-1989

La salida desde un gobierno autoritario supuso la conformación de dos agendas de cuestiones entendidas como procesos de problematización social: la agenda de transición, referida a la necesidad de transitar institucionalmente el cambio de gobierno y otra, más compleja, relativa a la apertura de procesos de democratización. Este trabajo analiza dos núcleos de demandas inscriptas en la agenda de democratización cordobesa y los itinerarios de los conflictos que expresan entre 1983 y 1989: las demandas por derechos humanos y las demandas estudiantiles. Las demandas asociadas al campo de los derechos humanos se configuran ligadas centralmente al proceso de extrañamiento generado por elterrorismo de Estado y la comisión de delitos de lesa humanidad en el pasado inmediato, ejemplo de las nuevas urgencias de la democracia en ciernes. Por su parte, las demandas estudiantiles surgen asociadas al proceso de reinstitucionalización de los espacios educativos, especialmente a los universitarios en los que el movimiento estudiantil había tenido un rol destacado como espacio y formato de politización juvenil y, por ello, una participación también importante en el universo de los represaliados de la última dictadura. El objetivo de la ponencia es presentar los itinerarios de ambos núcleos de demandas, relacionando los conflictos que expresan y sus configuraciones con los diferentes ciclos de la conflictividad social del períodoFil: Solís, Ana Carol. Universidad Nacional de CórdobaFil: Puttini, María Paula. Universidad Nacional de Córdob

Primary and secondary autoimmune neutropenia

Antineutrophil antibodies are well recognized causes of neutropenia, producing both quantitative and qualitative defects in neutrophils and increased risk for infection. In primary autoimmune neutropenia (AIN) of infancy, a moderate to severe neutropenia is the sole abnormality; it is rarely associated with serious infections and exhibits a self-limited course. Chronic idiopathic neutropenia of adults is characterized by occurrence in late childhood or adulthood, greater prevalence among females than among males, and rare spontaneous remission. Secondary AIN is more commonly seen in adults and underlying causes include collagen disorders, drugs, viruses and lymphoproliferative disorders. In most patients with AIN, antibodies recognize antigens located on the IgG Fc receptor type 3b but other target antigens have been recently identified in secondary AIN. Granulocyte colony-stimulating factor is a proven treatment in patients with AIN of all types and is now preferred to other possible therapies

El curanderismo y el campo de la salud en Brasil

Objetivos: Describir el poder médico hegemónico en el campo de la salud, así como examinar sus relaciones con las prácticas de curanderismo en Brasil

AB0951 THE ITALIAN FIBROMYALGIA REGISTRY: A NEW WAY OF USING ROUTINE REAL-WORLD DATA CONCERNING PATIENT-REPORTED DISEASE STATUS IN HEALTHCARE RESEARCH AND CLINICAL PRACTICE

Background:Fibromyalgia (FM), the most frequently encountered cause of widespread musculoskeletal pain, affects an estimated 2% of the general Italian population. However, it is not a homogeneous clinical entity, and a number of interacting factors can influence patient prognosis and the outcomes of standardised treatment programmes. Registries are a source of high-quality data for clinical research, but relating this information to individual patients is technically challenging.Objectives:The aim of this article is to describe the structure and objectives of the first Italian Fibromyalgia Registry (IFR), a new web-based registry of patients with FM.Methods:The IFR was developed to collect, store, and share information electronically entered by physicians throughout Italy who are members of the Italian Society of Rheumatology and have a particular interest in FM. It has a web-based architecture that uses two separate servers and an encryption algorithm to ensure the confidentiality and integrity of the exchanged data. The questionnaires included on the platform are the Revised Fibromyalgia Impact Questionnaire (FIQR), the modified Fibromyalgia Assessment Status (ModFAS), and the Polysymptomatic Distress Scale (PDS).Results:The registry includes data relating to 2,339 patients (93.2% female) who satisfied the 1990 or 2010/2011 American College of Rheumatology Classification Criteria for Fibromyalgia at the time of diagnosis. At the time of this analysis, the patients had a mean age of 51.9 years (SD 11.5) and a mean disease duration of 7.3 years (SD 6.9). The majority were married (71.3%), and generally well educated. The overall median FIQR, ModFAS and PDS scores and 25th-75thpercentiles were respectively 61.16 (41.16-77.00), 8.91 (41.16-77.00), and 19.0 (13.00-24.00). The six highest scoring items indicating the greatest impact of the disease on the patients related to fatigue/energy (7.18), sleep quality (6.87), tenderness (6.69), pain (6.68), stiffness (6.66), and environmental sensitivity (6.35). A high proportion of the responding patients reported experiencing pain in the neck (80.46%), upper back (68.36%), and lower back (75.05%).Conclusion:The IFR is the most comprehensive FM registry in Italy, and provides healthcare professionals with a secure, reliable, and easy-to-use means of monitoring the patients' clinical progression, treatment history and treatment responses. This can help clinicians to plan patient management, facilitates research study patient recruitment, and provides the participating pain clinics with statistics based on real-world data. It also helps address the Italian Ministry of Health long-term goal of using precision medicine for chronic pain prevention and treatment. It is hoped that the IFR will enhance both scientific research and clinical practice.References:[1]Drolet BC, Johnson KB: Categorizing the world of registries 2008; 41: 1009–20.[2]Martinez JE, Paiva ES, Rezende MC, Heymann RE, Helfenstein M, Ranzolin A, et al.: EpiFibro (Brazilian Fibromyalgia Registry): data on the ACR classification and diagnostic preliminary criteria fulfillment and the follow-up evaluation. 2017; 57: 129–33[3]Whipple MO, McAllister SJ, Oh TH, Luedtke CA, Toussaint LL, Vincent A: Construction of a US fibromyalgia registry using the Fibromyalgia Research Survey criteria. 2013; 6: 398–99[4]Wolfe F, Smythe HA, Yunus MB, Bennett RM, Bombardier C, Goldenberg D, et al.: The American College of Rheumatology 1990 Criteria for the Classification of Fibromyalgia. Report of the Multicenter Criteria Committee. 1990; 33: 160–72Disclosure of Interests:None declare