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Albrecht PJ, Liu Y, Houk G, Ruggiero B, Banov D, Dockum M, Day A, Rice FL, Bassani G. Cutaneous targets for topical pain medications in patients with neuropathic pain: individual differential expression of biomarkers supports the need for personalized medicine. Pain Rep 2024; 9:e1119. [PMID: 38375092 PMCID: PMC10876238 DOI: 10.1097/pr9.0000000000001121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 08/30/2023] [Accepted: 11/07/2023] [Indexed: 02/21/2024] Open
Abstract
Introduction Numerous potential cutaneous targets exist for treating chronic pain with topically applied active pharmaceutical ingredients. This preliminary human skin tissue investigation was undertaken to characterize several key biomarkers in keratinocytes and provide proof-of-principle data to support clinical development of topical compounded formulations for peripheral neuropathic pain syndromes, such as postherpetic neuralgia (PHN). Objectives The study intended to identify objective biomarkers in PHN skin on a patient-by-patient personalized medicine platform. The totality of biopsy biomarker data can provide a tissue basis for directing individualized compounded topical preparations to optimize treatment efficacy. Methods Referencing 5 of the most common actives used in topical pain relief formulations (ketamine, gabapentin, clonidine, baclofen, and lidocaine), and 3 well-established cutaneous mediators (ie, neuropeptides, cannabinoids, and vanilloids), comprehensive immunolabeling was used to quantify receptor biomarkers in skin biopsy samples taken from ipsilateral (pain) and contralateral (nonpain) dermatomes of patients with PHN. Results Epidermal keratinocyte labeling patterns were significantly different among the cohort for each biomarker, consistent with potential mechanisms of action among keratinocytes. Importantly, the total biomarker panel indicates that the enriched PHN cohort contains distinct subgroups. Conclusion The heterogeneity of the cohort differences may explain studies that have not shown statistical group benefit from topically administered compounded therapies. Rather, the essential need for individual tissue biomarker evaluations is evident, particularly as a means to direct a more accurately targeted topical personalized medicine approach and generate positive clinical results.
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Affiliation(s)
| | - Yi Liu
- Professional Compounding Centers of America (PCCA), Houston, TX, USA
| | - George Houk
- Integrated Tissue Dynamics, LLC (INTiDYN), Rensselaer, NY, USA
| | - Beth Ruggiero
- Integrated Tissue Dynamics, LLC (INTiDYN), Rensselaer, NY, USA
| | - Daniel Banov
- Professional Compounding Centers of America (PCCA), Houston, TX, USA
| | - Marilyn Dockum
- Integrated Tissue Dynamics, LLC (INTiDYN), Rensselaer, NY, USA
| | - A.J. Day
- Professional Compounding Centers of America (PCCA), Houston, TX, USA
| | - Frank L. Rice
- Integrated Tissue Dynamics, LLC (INTiDYN), Rensselaer, NY, USA
| | - Gus Bassani
- Professional Compounding Centers of America (PCCA), Houston, TX, USA
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Frumer L, Marom Harel H, Horesh D. Why Does It Hurt So Much? Emotion Regulation Mediates the Association between Fibromyalgia Symptoms and Psychological Distress. Healthcare (Basel) 2023; 11:healthcare11101368. [PMID: 37239659 DOI: 10.3390/healthcare11101368] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 05/02/2023] [Accepted: 05/08/2023] [Indexed: 05/28/2023] Open
Abstract
While it is known that fibromyalgia patients often suffer from depression and stress symptoms, there is inconclusive evidence as to why these symptoms occur. The aim of this study is to examine the role of emotion regulation in mental health symptoms among treatment-seeking individuals with fibromyalgia. Ninety-three (93) participants (mean age = 47.25, SD = 12.4) were recruited from one of Israel's largest community healthcare providers. They were administered self-report questionnaires assessing fibromyalgia (FIQR), perceived stress (PSS), major depression (PHQ-9), and difficulties in emotion regulation (DERS). Associations were found between measures of fibromyalgia symptoms, psychological distress, and emotion regulation. Several sub-indices of emotion regulation showed significant correlations with psychological distress, with non-acceptance of emotional responses showing the strongest associations. Moreover, non-acceptance of emotion responses mediated the association between fibromyalgia symptoms and psychological distress. Our findings show that the connection between fibromyalgia symptoms and psychological distress is partially explained by difficulties in emotion regulation. Moreover, we show that specific emotion regulation strategies play a differential role in fibromyalgia patients' distress, thereby highlighting the importance of identifying unique psychotherapeutic targets. Specifically, regulating emotions through acceptance of emotional responses seems to be particularly important for fibromyalgia patients, as they cope with stigma and a lack of validation.
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Affiliation(s)
- Lee Frumer
- Department of Psychology, Bar-Ilan University, Ramat-Gan 5290002, Israel
| | | | - Danny Horesh
- Department of Psychology, Bar-Ilan University, Ramat-Gan 5290002, Israel
- Department of Psychiatry, New York University Grossman School of Medicine, New York, NY 10016, USA
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Adams N, McVeigh JM, Cuesta-Vargas A, Abokdeer S. Evidence-based approaches for the management of fibromyalgia syndrome: a scoping review. PHYSICAL THERAPY REVIEWS 2023. [DOI: 10.1080/10833196.2022.2157945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Affiliation(s)
- Nicola Adams
- Faculty of Health and Life Sciences, Northumbria University, Newcastle-upon-Tyne, UK
| | - Joseph M McVeigh
- School of Clinical Therapies, College of Medicine and Health, University College Cork, Cork, Ireland
| | | | - Sedik Abokdeer
- Olympic Center for Physical Therapy and Rehabilitation, Tripoli, Libya
- Foreign Libyan Medical Center for Physiotherapy and Orthopaedics, Al-Zawia, Libya
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Prevalence of fibromyalgia in medical students and its association with lifestyle factors - a cross-sectional study. Reumatologia 2021; 59:138-145. [PMID: 34538940 PMCID: PMC8436804 DOI: 10.5114/reum.2021.106908] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Accepted: 05/12/2021] [Indexed: 12/05/2022] Open
Abstract
Objectives Fibromyalgia (FM) is a chronic widespread pain syndrome, known to be associated with several other symptoms. Chronic stress is suspected to be a contributing factor in the pathogenesis of FM. It is known that medical students are under a constant state of stress originating from personal and social expectations. The aim of the study was to assess the prevalence of FM in this population and identify lifestyle parameters influencing FM severity. Material and methods An online survey of first- and final-year medical students was conducted using the ACR modified 2016 criteria and FANTASTIC checklist. The survey acquired demographic information such as age, gender, year, and division of studies. A subgroup analysis based on gender, year of studies, and division of studies was performed. Results 439 medical students (71% females) completed the survey. The overall prevalence of FM in our cohort was 10.48%. The ratio of females to males was 3 : 1. A significant negative correlation between better quality of lifestyle and worse FM severity was observed in all subgroups. The “insight”, “sleep and stress”, “behavior” and “career” domains of lifestyle were found to have a significant negative correlation with FM severity on univariate analysis. Conclusions The prevalence of FM in medical students seems to be considerably higher than in the general population. Chronic stress levels, sleep problems, social support, and behavior seem to be the major factors influencing FM severity in this population. Our findings suggest that medical students must be considered a “high-risk” group for FM, and hence must be identified, educated, and managed accordingly. It is, therefore, important for medical universities to implement programs educating students about FM, the importance of a healthy lifestyle, and stress coping strategies, while also making systemic changes to curb stressors in medical training.
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Al-Smadi AM, Tawalbeh LI, Gammoh OS, Ashour AF, Shajrawi A, Attarian H. Relationship between anxiety, post-traumatic stress, insomnia and fibromyalgia among female refugees in jordan: A cross-sectional study. J Psychiatr Ment Health Nurs 2021; 28:738-747. [PMID: 33448096 DOI: 10.1111/jpm.12732] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2019] [Revised: 01/04/2021] [Accepted: 01/07/2021] [Indexed: 11/28/2022]
Abstract
UNLABELLED WHAT IS KNOWN ON THE SUBJECT?: Fibromyalgia (FM) is a syndrome of chronic widespread pain, typically associated with fatigue, sleep, cognitive dysfunction and disordered mood. FM may limit an individual's ability to participate in everyday work and social activities, thereby making it difficult to maintain normal relationships with other individuals. While it has been studied in different populations and settings, the impact of FM and associated psychological factors has not been previously studied among female war refugees. WHAT DOES THE PAPER ADD TO EXISTING KNOWLEDGE?: The study showed the high impact of FM on female refugees in Jordan; approximately three quarters of the participants had a moderate to severe FM impact. Refugees settled in Irbid city, Iraq, showed increased age, anxiety and post-traumatic stress disorder correlated with a higher FM impact. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: The study recommends evaluation of the impact of FM among all female refugees living in Jordan, along with its neighbouring countries hosting refugees. Healthcare providers, including mental health nurses, should be aware of the role of PTSD and anxiety on the impact of FM. Accordingly, healthcare workers should design appropriate mental health treatment plans to help to decrease the impact of FM. Mental health nurses should evaluate FM impact among all refugees worldwide. Nurses in Jordan are recommended to share their experience with nurses outside of Jordan as this may help with funds being obtained and the implementation of advanced psychological interventions. ABSTRACT INTRODUCTION: Fibromyalgia (FM) is a syndrome of chronic widespread pain. While it has been studied in different populations and settings, the impact of FM and its associated psychological factors has not been previously studied among female war refugees. AIM To assess the impact of FM and its associated factors in female refugees. METHODS A cross-sectional study was conducted. The impact of FM, anxiety, post-traumatic stress (PTSD) and insomnia was investigated. RESULTS 288 refugees previously diagnosed with FM were recruited. The results showed that 73.62% of the participants had a moderate to severe FM impact. Refugees settled in Irbid city were six times more likely to have a higher FM impact than refugees settled in Zarqa, and Iraqi refugees were more likely to have a higher impact than Syrian. Increased age, anxiety and PTSD were correlated with a greater impact. CONCLUSION Mental health nursing services should be directed towards female refugees, particularly those with increased age, anxiety and PTSD. IMPLICATIONS FOR PRACTICE Mental health nurses should evaluate the FM impact among all refugees worldwide. Furthermore, nurses in Jordan are recommended to share their experiences with nurses outside of Jordan, as this may help to raise funds and implement advanced psychological interventions.
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Affiliation(s)
| | | | - Omar Salem Gammoh
- Faculty of Health Sciences, American University of Madaba, Amman, Jordan
| | | | | | - Hrayr Attarian
- Division of Sleep Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois
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Nugraha B, Scheibe R, Korallus C, Gaestel M, Gutenbrunner C. The p38/MK2 Axis in Monocytes of Fibromyalgia Syndrome Patients: An Explorative Study. ACTA ACUST UNITED AC 2021; 57:medicina57040396. [PMID: 33921654 PMCID: PMC8072914 DOI: 10.3390/medicina57040396] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 04/12/2021] [Accepted: 04/16/2021] [Indexed: 12/30/2022]
Abstract
Background and Objectives: The aetiology and pathomechanism of fibromyalgia syndrome 12 (FMS) as one of chronic pain syndromes still need to be further elucidated. Mitogen-activated protein kinase (MAPK) pathway has been proposed as a novel approach in pain management. Since the major symptom of fibromyalgia syndrome (FMS) patients is pain, it became of interest whether MAPK pathways, such as the stress-activated p38 MAPK/MK2 axis, are activated in FMS patients. Therefore, this study aimed at determining p38 MAPK/MK2 in FMS patients. Materials and Methods: Phosphorylation of MAPK-activated protein kinases 2 (MK2), a direct target of p38 MAPK, was measured in monocytes of FMS and healthy controls (HCs) to monitor the activity of this pathway. Results: The mean level of phosphorylated MK2 was fivefold higher in FMS patients as compared to HCs (p < 0.001). Subgroup analysis revealed that antidepressants did not influence the activity of MK2 in FMS patients. Conclusions: This result indicates that the p38/MK2 pathway could be involved in the pathomechanism of FMS, could act as a clinical marker for FMS, and could be a possible target for pain management in FMS patients.
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Affiliation(s)
- Boya Nugraha
- Department of Rehabilitation Medicine, Hannover Medical School, Carl-Neuberg-Str.1, 30625 Hannover, Germany;
- Correspondence: (B.N.); (C.G.); Tel.: +49-511-532-9197 (B.N.)
| | - Renate Scheibe
- Institute of Cell Biochemistry, Hannover Medical School, Carl-Neuberg-Str.1, 30625 Hannover, Germany; (R.S.); (M.G.)
| | - Christoph Korallus
- Department of Rehabilitation Medicine, Hannover Medical School, Carl-Neuberg-Str.1, 30625 Hannover, Germany;
| | - Matthias Gaestel
- Institute of Cell Biochemistry, Hannover Medical School, Carl-Neuberg-Str.1, 30625 Hannover, Germany; (R.S.); (M.G.)
| | - Christoph Gutenbrunner
- Department of Rehabilitation Medicine, Hannover Medical School, Carl-Neuberg-Str.1, 30625 Hannover, Germany;
- Correspondence: (B.N.); (C.G.); Tel.: +49-511-532-9197 (B.N.)
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Şen ÇakiroĞlu G, Hİzmetlİ S, SİlİĞ Y, KaradaĞ A, Hayta E, Özaltin B, TaŞ A, Zontul C. Comparison of Beta-2 Adrenergic Receptor Gene Polymorphisms Between Patients with Fibromyalgia Syndrome and Healthy Controls. Arch Rheumatol 2021; 35:328-334. [PMID: 33458655 PMCID: PMC7788641 DOI: 10.46497/archrheumatol.2020.7602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Accepted: 10/05/2019] [Indexed: 11/03/2022] Open
Abstract
Objectives This study aims to compare the beta-2 adrenergic receptor (ADRB2) gene polymorphisms of patients with fibromyalgia syndrome (FMS) with those of healthy control subjects, and to investigate the possible relationship between symptoms of FMS and polymorphisms of the ADRB2 gene. Patients and methods The study included 170 females (mean age 47.8±10.3 years; range, 21 to 75 years) diagnosed with FMS according to the 2010 American College of Rheumatology criteria and 170 healthy females (mean age 47.2±8.8 years; range, 20 to 72 years) as the control group. Several clinical symptoms of the participants related to FMS were questioned and recorded. The visual analog scale (VAS) and Fibromyalgia Impact Questionnaire (FIQ) scores of the fibromyalgia group were recorded. In both groups, the ADRB2 (rs1042717) single-nucleotide polymorphism was detected by way of a real-time polymerase chain reaction. The wild-type (Guanine/Guanine), the mutant type (Adenine/Adenine) and heterozygous type (Adenine/Guanine) were detected. The sample power was calculated considering the minor allele frequency. Results The comparison of the ADRB2 gene polymorphism between patients with FMS and the control subjects showed that the groups were similar in terms of ADBR2 gene polymorphism and genotype (p>0.05). There was no significant difference in terms of genotype when the ADRB2 gene polymorphisms in patients with FMS were compared in terms of clinical symptoms, VAS and FIQ scores (p>0.05). Conclusion Beta-2 adrenergic receptor (rs1042717) gene polymorphisms and genotype distribution are no different between patients with FMS and healthy individuals. ADRB2 gene polymorphisms in patients with FMS have no effect on clinical symptoms and VAS and FIQ scores. The results of the present study will light the way for future research into ADRB2 gene polymorphisms in the pathogenesis of FMS.
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Affiliation(s)
- Gözde Şen ÇakiroĞlu
- Department of Physical Medicine and Rehabilitation, Niğde State Hospital, Niğde, Turkey
| | - Sami Hİzmetlİ
- Department of Physical Medicine and Rehabilitation, Cumhuriyet University Faculty of Medicine, Sivas, Turkey
| | - Yavuz SİlİĞ
- Department of Biochemistry, Cumhuriyet University Faculty of Medicine, Sivas, Turkey
| | - Ahmet KaradaĞ
- Department of Physical Medicine and Rehabilitation, Cumhuriyet University Faculty of Medicine, Sivas, Turkey
| | - Emrullah Hayta
- Department of Physical Medicine and Rehabilitation, Acıbadem Hospital, İstanbul, Turkey
| | - Burcu Özaltin
- Department of Physical Medicine and Rehabilitation, Anamur State Hospital, Mersin, Turkey
| | - Ayça TaŞ
- Department of Biochemistry, Cumhuriyet University Faculty of Medicine, Sivas, Turkey
| | - Cemile Zontul
- Department of Biochemistry, Cumhuriyet University Faculty of Medicine, Sivas, Turkey
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8
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Reyes del Paso GA, de la Coba P. Reduced activity, reactivity and functionality of the sympathetic nervous system in fibromyalgia: An electrodermal study. PLoS One 2020; 15:e0241154. [PMID: 33119628 PMCID: PMC7595305 DOI: 10.1371/journal.pone.0241154] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2020] [Accepted: 09/29/2020] [Indexed: 02/07/2023] Open
Abstract
Alterations in autonomic activity are well established in fibromyalgia syndrome (FMS). Previous studies found reduced parasympathetic activity and sympathetic reactivity to physical and stress manipulations. However, sympathetic activity at rest has not been well studied in FMS. Sweating is exclusively controlled by sympathetic mechanisms. In this study, skin conductance (SC), as an indirect measure of sweating, was analyzed in 45 women with FMS and 38 healthy women. Tonic SC levels were recorded during a 4-minute rest period, and a breathing maneuver consisting of deep breathing with posterior breath holding was used to evoke SC responses. Associations of tonic SC with state anxiety and body temperature, measured in the hand, were explored to determine sweat functionality. The results showed reduced tonic SC levels, with a less marked decrease in SC during the recording period, and blunted SC reactivity to the breathing manipulation in FMS patients relative to healthy participants. Positive associations of SC with state anxiety and body temperature were observed in healthy participants, but these associations were absent in FMS patients. These results indicate alterations of sweating in FMS, suggesting reduced tonic and reactivity sympathetic influences. Furthermore, the absence of associations between SC levels and state anxiety and body temperature in the patient sample suggested a loss of functionality of the autonomic nervous system in FMS. Diminished autonomic regulation in FMS would reduce the ability to cope with environmental demands, thus favoring increases in stress and pain levels. Finally, the observed reduction in sweating is in accordance with evidence of small nerve fiber neuropathy in FMS.
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Affiliation(s)
| | - Pablo de la Coba
- Department of Psychology, University of Jaén, Jaén, Spain
- * E-mail:
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Hazra S, Venkataraman S, Handa G, Yadav SL, Wadhwa S, Singh U, Kochhar KP, Deepak KK, Sarkar K. A Cross-Sectional Study on Central Sensitization and Autonomic Changes in Fibromyalgia. Front Neurosci 2020; 14:788. [PMID: 32848561 PMCID: PMC7417433 DOI: 10.3389/fnins.2020.00788] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Accepted: 07/06/2020] [Indexed: 12/15/2022] Open
Abstract
Fibromyalgia is a multi-symptomatic disorder characterized by generalized pain. The pathophysiology of fibromyalgia is supposedly an interplay between central nervous system hyper-responsiveness, autonomic dysfunction, and peripheral pain. In this cross-sectional study, the objective was to assess central sensitization and autonomic activity in patients with fibromyalgia compared with control. Fifty adults diagnosed with fibromyalgia by the modified American College of Rheumatology 2010 criteria and an equal number of age- and sex-matched controls participated in the study in an urban tertiary care hospital. Central sensitization was assessed by history and by evidence of increased prefrontal cortical activity as measured by cortical oxygenation using functional near-infrared spectroscopy. Autonomic activity was assessed by heart rate variability, electrodermal activity, and deep breathing test in three physiological states: rest, sympathetic stress (cold pressor test), and deep breathing. Mann–Whitney U-test, paired t-test, Wilcoxon test, and Friedman test with Bonferroni a priori were used to analyze the data. Cortical activity was significantly higher in the fibromyalgia group than control. There was no significant difference in autonomic activity between the fibromyalgia and control groups. In the fibromyalgia group, variable degrees of sympathetic hyperactivity and normal parasympathetic activity were observed. Central sensitization may be playing a primary role in the pathophysiology of generalized pain in fibromyalgia.
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Affiliation(s)
- Sandipan Hazra
- Department of Physical Medicine and Rehabilitation, All India Institute of Medical Sciences, Jodhpur, India
| | - Srikumar Venkataraman
- Department of Physical Medicine and Rehabilitation, All India Institute of Medical Sciences, New Delhi, India
| | - Gita Handa
- Department of Physical Medicine and Rehabilitation, All India Institute of Medical Sciences, New Delhi, India
| | - S L Yadav
- Department of Physical Medicine and Rehabilitation, All India Institute of Medical Sciences, New Delhi, India
| | - Sanjay Wadhwa
- Department of Physical Medicine and Rehabilitation, All India Institute of Medical Sciences, New Delhi, India
| | - U Singh
- Department of Physical Medicine and Rehabilitation, All India Institute of Medical Sciences, New Delhi, India
| | - K P Kochhar
- Department of Physiology, All India Institute of Medical Sciences, New Delhi, India
| | - K K Deepak
- Department of Physiology, All India Institute of Medical Sciences, New Delhi, India
| | - Kaushik Sarkar
- Department of Electronics and Communication Engineering, Narula Institute of Technology, Kolkata, India
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Álvarez MC, Albuquerque MLL, Neiva HP, Cid L, Rodrigues F, Teixeira DS, Monteiro D. The Multidimensional Daily Diary of Fatigue-Fibromyalgia-17 Items (MDF-Fibro-17): Evidence from Validity, Reliability and Transcultural Invariance between Portugal and Brazil. J Clin Med 2020; 9:jcm9082330. [PMID: 32707855 PMCID: PMC7463927 DOI: 10.3390/jcm9082330] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 07/17/2020] [Accepted: 07/19/2020] [Indexed: 11/16/2022] Open
Abstract
The Multidimensional Daily Diary of Fatigue-Fibromyalgia-17 (MDF-fibro-17) is an instrument that measures the different components of fibromyalgia-related fatigue symptoms. The current study aims to examine the factor structure of the MDF-fibro-17 in a sample of Portuguese and Brazilian patients diagnosed with fibromyalgia. Additionally, a cross-cultural analysis was carried out on these samples to understand the multidimensional complexity of examining the different dimensions of fatigue in patients with different cultural backgrounds and how fibromyalgia impacts patients with this syndrome. A confirmatory factor analysis was performed to examine the psychometric properties of the measure. Additionally, a multigroup analysis was carried out on the samples of these two cultures to examine measurement invariance. In total, 209 Portuguese women aged between 21 and 75 years (M = 47.44; SD = 10.73) and 429 Brazilians women aged between 16 and 77 years (M = 46.51; SD = 9.24) participated in this study. The results revealed that the measurement model provided an acceptable fit to the data in both the Portuguese and Brazilian samples, also displaying acceptable convergent and discriminant validity. In addition, the model showed acceptable internal consistency and was invariant between cultures. In sum, the MDF-fibro-17 is a valid measure that offers a unique assessment of fatigue symptoms in Portuguese and Brazilian women with fibromyalgia.
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Affiliation(s)
- Marcos C. Álvarez
- Department of Sport Sciences, University of Beira Interior (UBI), 6201-001 Covilhã, Portugal; (M.C.Á.); (M.L.L.A.); (H.P.N.)
| | - Maria Luiza L. Albuquerque
- Department of Sport Sciences, University of Beira Interior (UBI), 6201-001 Covilhã, Portugal; (M.C.Á.); (M.L.L.A.); (H.P.N.)
| | - Henrique P. Neiva
- Department of Sport Sciences, University of Beira Interior (UBI), 6201-001 Covilhã, Portugal; (M.C.Á.); (M.L.L.A.); (H.P.N.)
- Research Center in Sport, Health and Humam Development (CIDESD), 5001-801 Vila Real, Portugal; (L.C.); (F.R.)
| | - Luís Cid
- Research Center in Sport, Health and Humam Development (CIDESD), 5001-801 Vila Real, Portugal; (L.C.); (F.R.)
- Sport Science School of Rio Maior, Polytechnique Institute of Santarém (ESDRM-IPSantarém), 2040-413 Rio Maior, Portugal
| | - Filipe Rodrigues
- Research Center in Sport, Health and Humam Development (CIDESD), 5001-801 Vila Real, Portugal; (L.C.); (F.R.)
- Sport Science School of Rio Maior, Polytechnique Institute of Santarém (ESDRM-IPSantarém), 2040-413 Rio Maior, Portugal
- Life Quality Research Center (CIEQV), 2040-413 Rio Maior, Portugal
| | - Diogo S. Teixeira
- Faculty of Physical Education and Sport (ULHT/FEFD), University of Lusófona, 1749-024 Lisbon, Portugal;
- Center for the Study of Human Performance (CIPER), 1495-751 Lisbon, Portugal
| | - Diogo Monteiro
- Research Center in Sport, Health and Humam Development (CIDESD), 5001-801 Vila Real, Portugal; (L.C.); (F.R.)
- Sport Science School of Rio Maior, Polytechnique Institute of Santarém (ESDRM-IPSantarém), 2040-413 Rio Maior, Portugal
- Correspondence:
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Nardi AE, Karam EG, Carta MG. Fibromyalgia patients should always be screened for post-traumatic stress disorder. Expert Rev Neurother 2020; 20:891-893. [PMID: 32662698 DOI: 10.1080/14737175.2020.1794824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Antonio E Nardi
- Institute of Psychiatry, Laboratory of Panic & Respiration, Federal University of Rio De Janeiro , Brazil.,Brazilian Academy of Sciences and National Academy of Medicine , Brazil
| | - Elie G Karam
- Head Institute for Development, Research, Advocacy & Applied Care (IDRAAC), Professor of Psychiatry & Clinical Psychology St. George Hospital University Medical Center University of Balamand , Lebanon.,Chairman of the World Psychiatric Association Epidemiology and Public Health Section , Geneve, Switzerland
| | - Mauro G Carta
- Department of Applied Biomedical Technologies, Università degli Studi di cagliari , Italy.,Dipartimento di Scienze Mediche e Sanità Pubblica, Università di Cagliari , Italy
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12
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Kocak I, Hizmetli S, Tas A, Karadag A, Zontul C, Silig Y. High levels of cathepsin S and cystatin C in patients with fibromyalgia syndrome. Int J Rheum Dis 2020; 23:966-969. [PMID: 32307906 DOI: 10.1111/1756-185x.13840] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Revised: 02/25/2020] [Accepted: 03/21/2020] [Indexed: 11/29/2022]
Abstract
OBJECTIVES Although the etiopathogenesis of fibromyalgia syndrome (FM) is not yet clear, central sensitization is thought to be responsible for the pathogenesis of FM. The aim of this study was to compare the serum cathepsin S (CatS) and cystatin C (CysC) levels between patients with FM and healthy control subjects. METHODS This study was conducted in the Physical Medicine and Rehabilitation Clinic between January 2019 and October 2019. The study included 145 FM patients newly diagnosed with primary FM according to the 2010 American College of Rheumatology criteria and 129 healthy volunteers. The age, gender, and body mass index (BMI) of the participants were recorded. Venous blood samples were collected from both groups for the measurement of the levels of serum CatS and CysC. The functional status of FM patients was evaluated using the Fibromyalgia Impact Questionnaire (FIQ). RESULTS No statistically significant difference was determined between the patient and control groups in terms of age, gender, and BMI (P > .05). A comparison of the serum CatS and CysC levels of the FM and control groups revealed a statistically significant difference (P = .001). No correlation was determined between FIQ and serum CatS and CysC levels (P > .05). CONCLUSION Serum CatS and CysC levels were found to be higher in FM patients. However, there was no correlation between the functional status of FM patients and serum CatS and CysC levels. These results can be of guidance for further clinical studies of the etiopathogenesis and treatment of FM.
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Affiliation(s)
- Ibrahim Kocak
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Cumhuriyet University, Sivas, Turkey
| | - Sami Hizmetli
- Department of Physical Medicine and Rehabilitation, Division of Rheumatology, Faculty of Medicine, Cumhuriyet University, Sivas, Turkey
| | - Ayça Tas
- Department of Nutrition and Diet, Faculty of Health Sciences, Cumhuriyet University, Sivas, Turkey
| | - Ahmet Karadag
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Cumhuriyet University, Sivas, Turkey
| | - Cemile Zontul
- Department of Biochemistry, Faculty of Medicine, Cumhuriyet University, Sivas, Turkey
| | - Yavuz Silig
- Department of Biochemistry, Faculty of Medicine, Cumhuriyet University, Sivas, Turkey
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Korucu RU, Karadağ A, Taş A, Özmen E, Hayta E, Siliğ Y. Serum Calcitonin Gene-Related Peptide and Receptor Protein Levels in Patients With Fibromyalgia Syndrome: A Cross-Sectional Study. Arch Rheumatol 2020; 35:463-467. [PMID: 33758802 PMCID: PMC7945696 DOI: 10.46497/archrheumatol.2020.7783] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Accepted: 11/02/2019] [Indexed: 11/20/2022] Open
Abstract
Objectives
This study aims to compare the serum calcitonin gene-related peptide (CGRP) and CGRP receptor protein levels between patients with fibromyalgia syndrome (FM) and healthy control subjects. Patients and methods
The study included 88 patients (7 males, 81 females; mean age 44.5±9.1 years; range, 20 to 72 years) newly-diagnosed with FM according to the 2010 American College of Rheumatology criteria and 88 healthy volunteers (6 males, 82 females; mean age 43.0±6.1 years; range, 20 to 57 years). Venous blood samples were collected from both groups for the measurement of the levels of serum CGRP and CGRP receptor proteins (receptor component protein [RCP], receptor activity modifying protein 1 [RAMP 1] and calcitonin receptor-like receptor [CLR]). Results
A comparison of the serum CGRP, CLR and RCP levels of the FM and control groups revealed a statistically significant difference (p=0.001, p=0.005, p=0.001, respectively). The difference between the groups in respect of the serum RAMP 1 levels was not statistically significant (p=0.107). Conclusion The serum CGRP, CLR and RCP levels were found to be higher in the FM patients, but no difference was determined between the FM patients and the healthy control group in respect of the RAMP 1 level. These results can be of guidance for further clinical studies of the etiopathogenesis and treatment of FM.
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Affiliation(s)
- Ragıp Ulvi Korucu
- Department of Physical Medicine and Rehabilitation, Cumhuriyet University Faculty of Medicine, Sivas, Turkey
| | - Ahmet Karadağ
- Department of Physical Medicine and Rehabilitation, Cumhuriyet University Faculty of Medicine, Sivas, Turkey
| | - Ayça Taş
- Department of Biochemistry, Cumhuriyet University Faculty of Medicine, Sivas, Turkey
| | - Esma Özmen
- Department of Biochemistry, Cumhuriyet University Faculty of Medicine, Sivas, Turkey
| | - Emrullah Hayta
- Department of Physical Medicine and Rehabilitation, Acıbadem University Faculty of Medicine, Istanbul, Turkey
| | - Yavuz Siliğ
- Department of Biochemistry, Cumhuriyet University Faculty of Medicine, Sivas, Turkey
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Serum Vascular Endothelial Growth Factor and Vascular Endothelial Growth Factor Receptor-1 Levels in Patients With Fibromyalgia Syndrome. Arch Rheumatol 2020; 34:414-418. [PMID: 32010890 DOI: 10.5606/archrheumatol.2019.7265] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2018] [Accepted: 02/10/2019] [Indexed: 01/01/2023] Open
Abstract
Objectives This study aims to compare the serum vascular endothelial growth factor (VEGF) and vascular endothelial growth factor receptor-1 (VEGFR-1) levels between patients with fibromyalgia syndrome (FMS) and healthy controls. Patients and methods The study included 40 female patients (mean age 39.9±10.2 years; range, 22 to 52 years) diagnosed with primary FMS according to the American College of Rheumatology criteria (1990) and 40 healthy female volunteers (mean age 40.9±8.3 years; range, 25 to 53 years). The sociodemographic data of both groups were recorded. The disease duration and the number of tender points were recorded for patients with FMS, and venous blood samples were collected from the two groups for the measurement of serum VEGF and VEGFR-1 levels. Results The FMS and control groups were comparable in terms of age and body mass index (p>0.05). A comparison of the serum VEGF levels of the FMS and control groups revealed a statistically insignificant difference (p>0.05), while a comparison of the serum VEGF-1 levels of the FMS and control groups revealed a statistically significant difference (p<0.05). Conclusion Serum VEGFR-1 levels were higher in patients with FMS, while the serum VEGF levels of the FMS patients did not differ from those of the healthy controls.
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Türkoğlu G, Selvi Y. The relationship between chronotype, sleep disturbance, severity of fibromyalgia, and quality of life in patients with fibromyalgia. Chronobiol Int 2019; 37:68-81. [DOI: 10.1080/07420528.2019.1684314] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- Gözde Türkoğlu
- Department of Physical Medicine and Rehabilitation, Konya Training and Research Hospital, Konya, Turkey
| | - Yavuz Selvi
- Department of Psychiatry, Selcuk University Faculty of Medicine, Konya, Turkey
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Kim J, Kim SR, Lee H, Nam DH. Comparing Verum and Sham Acupuncture in Fibromyalgia Syndrome: A Systematic Review and Meta-Analysis. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2019; 2019:8757685. [PMID: 31534469 PMCID: PMC6732586 DOI: 10.1155/2019/8757685] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Revised: 07/09/2019] [Accepted: 08/01/2019] [Indexed: 12/13/2022]
Abstract
OBJECTIVES Acupuncture is often used for relieving symptoms of fibromyalgia syndrome (FMS). Our aim is to ascertain whether verum acupuncture is more effective than sham acupuncture in FMS. METHODS We collected RCTs to investigate the effects of verum acupuncture and sham acupuncture on pain, sleep quality, fatigue, and general status in FMS patients. The databases used for data retrieval were PubMed, Central Cochrane, EMBASE, PsycINFO, CNKI, VIP, OASIS, KoreaMed, and RISS. Selection/exclusion from the retrieved records was performed according to prespecified criteria, and the final selected records were assessed according to the Cochrane risk of bias tool. The results of the included trials were synthesized on the basis of outcomes, and subgroup analysis depended on the type of add-on sham acupuncture that was performed. RESULTS Ten RCTs (690 participants) were eligible, and eight RCTs were eventually included in the meta-analysis. The synthesis showed a sizable effect of verum acupuncture compared with sham acupuncture on pain relief (standardized mean difference (SMD) -0.49, Z = 3.26, P=0.001; I 2 = 59%), improving sleep quality (SMD -0.46, Z = 3.24, P=0.001; I 2 = 0%), and reforming general status (SMD -0.69, Z = 6.27, P < 0.00001; I 2 = 4%). However, efficacy on fatigue was insignificant (SMD -0.10, Z = 0.51, P=0.61; I 2 = 46%). When compared with a combination of simulation and improper location of needling, the effect of verum acupuncture for pain relief was the most obvious. CONCLUSIONS Verum acupuncture is more effective than sham acupuncture for pain relief, improving sleep quality, and reforming general status in FMS posttreatment. However, evidence that it reduces fatigue was not found.
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Affiliation(s)
- Jiwon Kim
- Department of Biofunctional Medicine and Diagnosis, College of Korean Medicine, Sangji University, Wonju, Republic of Korea
| | - Su-Ryun Kim
- Department of Biofunctional Medicine and Diagnosis, College of Korean Medicine, Sangji University, Wonju, Republic of Korea
| | - Hyangsook Lee
- Department of Anatomy, College of Korean Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Dong-Hyun Nam
- Department of Biofunctional Medicine and Diagnosis, College of Korean Medicine, Sangji University, Wonju, Republic of Korea
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17
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The evolution and multi-molecular properties of NF1 cutaneous neurofibromas originating from C-fiber sensory endings and terminal Schwann cells at normal sites of sensory terminations in the skin. PLoS One 2019; 14:e0216527. [PMID: 31107888 PMCID: PMC6527217 DOI: 10.1371/journal.pone.0216527] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Accepted: 04/24/2019] [Indexed: 12/30/2022] Open
Abstract
In addition to large plexiform neurofibromas (pNF), NF1 patients are frequently disfigured by cutaneous neurofibromas (cNF) and are often afflicted with chronic pain and itch even from seemingly normal skin areas. Both pNFs and cNF consist primarily of benign hyperproliferating nonmyelinating Schwann cells (nSC). While pNF clearly arise within deep nerves and plexuses, the role of cutaneous innervation in the origin of cNF and in chronic itch and pain is unknown. First, we conducted a comprehensive, multi-molecular, immunofluorescence (IF) analyses on 3mm punch biopsies from three separate locations in normal appearing, cNF-free skin in 19 NF1 patients and skin of 16 normal subjects. At least one biopsy in 17 NF1 patients had previously undescribed micro-lesions consisting of a small, dense cluster of nonpeptidergic C-fiber endings and the affiliated nSC consistently adjoining adnexal structures—dermal papillae, hair follicles, sweat glands, sweat ducts, and arterioles—where C-fiber endings normally terminate. Similar micro-lesions were detected in hind paw skin of mice with conditionally-induced SC Nf1-/- mutations. Hypothesizing that these microlesions were pre-cNF origins of cNF, we subsequently analyzed numerous overt, small cNF (s-cNF, 3–6 mm) and discovered that each had an adnexal structure at the epicenter of vastly increased nonpeptidergic C-fiber terminals, accompanied by excessive nSC. The IF and functional genomics assays indicated that neurturin (NTRN) and artemin (ARTN) signaling through cRET kinase and GFRα2 and GFRα3 co-receptors on the aberrant C-fiber endings and nSC may mutually promote the onset of pre-cNF and their evolution to s-cNF. Moreover, TrpA1 and TrpV1 receptors may, respectively, mediate symptoms of chronic itch and pain. These newly discovered molecular characteristics might be targeted to suppress the development of cNF and to treat chronic itch and pain symptoms in NF1 patients.
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Ranque-Garnier S, Eldin C, Sault C, Raoult D, Donnet A. Management of patients presenting with generalized musculoskeletal pain and a suspicion of Lyme disease. Med Mal Infect 2019; 49:157-166. [DOI: 10.1016/j.medmal.2019.01.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Accepted: 01/17/2019] [Indexed: 10/27/2022]
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Galvez-Sánchez CM, Duschek S, Reyes Del Paso GA. Psychological impact of fibromyalgia: current perspectives. Psychol Res Behav Manag 2019; 12:117-127. [PMID: 30858740 PMCID: PMC6386210 DOI: 10.2147/prbm.s178240] [Citation(s) in RCA: 156] [Impact Index Per Article: 31.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Fibromyalgia syndrome (FMS) is a chronic disorder characterized by widespread and persistent musculoskeletal pain and other frequent symptoms such as fatigue, insomnia, morning stiffness, cognitive impairment, depression, and anxiety. FMS is also accompanied by different comorbidities like irritable bowel syndrome and chronic fatigue syndrome. Although some factors like negative events, stressful environments, or physical/emotional traumas may act as predisposing conditions, the etiology of FMS remains unknown. There is evidence of a high prevalence of psychiatric comorbidities in FMS (especially depression, anxiety, borderline personality, obsessive-compulsive personality, and post-traumatic stress disorder), which are associated with a worse clinical profile. There is also evidence of high levels of negative affect, neuroticism, perfectionism, stress, anger, and alexithymia in FMS patients. High harm avoidance together with high self-transcendence, low cooperativeness, and low self-directedness have been reported as temperament and character features in FMS patients, respectively. Additionally, FMS patients tend to have a negative self-image and body image perception, as well as low self-esteem and perceived self-efficacy. FMS reduces functioning in physical, psychological, and social spheres, and also has a negative impact on cognitive performance, personal relationships (including sexuality and parenting), work, and activities of daily life. In some cases, FMS patients show suicidal ideation, suicide attempts, and consummated suicide. FMS patients perceive the illness as a stigmatized and invisible disorder, and this negative perception hinders their ability to adapt to the disease. Psychological interventions may constitute a beneficial complement to pharmacological treatments in order to improve clinical symptoms and reduce the impact of FMS on health-related quality of life.
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Affiliation(s)
| | - Stefan Duschek
- Department of Psychology, University for Health Sciences, Medical Informatics and Technology, Hall in Tirol, Austria
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Huchon C, Aubry G, Ploteau S, Fauconnier A. [Specific clinical signs suggestive of endometriosis (excluding adenomyosis) and questionnaires of symptoms, pain and quality of life: CNGOF-HAS Endometriosis Guidelines]. ACTA ACUST UNITED AC 2018. [PMID: 29530559 DOI: 10.1016/j.gofs.2018.02.022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
In case of consultation for chronic pelvic pain or suspicion of endometriosis, it is recommended to evaluate the pain (intensity, resonance) and to search out the evocative and localizing symptoms of endometriosis (Grade B). The main symptoms suggestive of endometriosis are: severe dysmenorrhea (NP2), deep dyspareunia (NP2), painful defecation during menstruation (NP2), urinary tract symptoms during menstruation (NP2) and infertility (NP2). In patients with chronic pelvic pain, it is recommended to search deep infiltrating endometriosis in patients with painful defecation during menstruation or severe deep dyspareunia (Grade B). It is recommended to search symptoms suggestive of sensitization in painful patients with endometriosis (Grade B). When suggestive symptoms of endometriosis are present, a directed gynecological examination is recommended, where possible, including examination of the posterior vaginal cul-de-sac (Grade C). In assessing pain intensity or evaluating analgesic effectiveness of a treatment, it is recommended to use a scale to measure the intensity of pain (Grade A). In the management of symptomatic endometriosis, it is recommended to evaluate the quality of life (Grade C).
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Affiliation(s)
- C Huchon
- Service de gynécologie & obstétrique, CHI Poissy-St-Germain-en-Laye, Université Versailles-Saint-Quentin en Yvelines, 10, rue du champ Gaillard, BP 3082, 78303 Poissy cedex, France.
| | - G Aubry
- Service de gynécologie-obstétrique, CHI Poissy-St-Germain, 10, rue du Champ-Gaillard, 78303 Poissy, France
| | - S Ploteau
- Service de gynécologie-obstétrique et médecine de la reproduction, hôpital Mère-Enfant, CHU de Nantes, 8, boulevard Jean-Monnet, 44093 Nantes, France
| | - A Fauconnier
- Service de gynécologie & obstétrique, CHI Poissy-St-Germain-en-Laye, Université Versailles-Saint-Quentin en Yvelines, 10, rue du champ Gaillard, BP 3082, 78303 Poissy cedex, France
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Hernandez-Leon A, De la Luz-Cuellar YE, Granados-Soto V, González-Trujano ME, Fernández-Guasti A. Sex differences and estradiol involvement in hyperalgesia and allodynia in an experimental model of fibromyalgia. Horm Behav 2018; 97:39-46. [PMID: 29080671 DOI: 10.1016/j.yhbeh.2017.10.011] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2017] [Revised: 09/21/2017] [Accepted: 10/24/2017] [Indexed: 01/04/2023]
Abstract
Fibromyalgia (FM) is a musculoskeletal chronic pain syndrome. Its prevalence in women is higher than in men possibly by hormonal factors given that symptoms are aggravated during sex hormone-related events, such as the premenstrual period, pregnancy, postpartum or menopause. The aim of the present study was to investigate whether hyperalgesia and allodynia, in reserpine-induced experimental FM, depend on sex, estrous cycle, ovariectomy and replacement with 17β-estradiol. To fulfill this objective, we compared males, intact females with known estrous cycle phases and ovariectomized (OVX) rats treated with 17β-estradiol. Data demonstrated that reserpine administration disrupted the normal estrous cycle and produced that all females entered metestrus/diestrus. In addition, this treatment leads to muscle hyperalgesia and tactile allodynia in a similar manner in male and intact female rats. However, the absence of ovarian hormones (in OVX rats) increased muscle nociception. 17β-estradiol (2.5-10μg/rat) produced antihyperalgesic and antiallodynic effects 24h, but not 8h, after its administration, suggesting a genomic mechanism. The present results support the validity of the reserpine-induced FM model for searching alternatives of treatment, particularly during endocrine phases when pain is exacerbated such as menopause, and that 17β-estradiol replacement might be useful.
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Affiliation(s)
- Alberto Hernandez-Leon
- Departamento de Farmacobiología, Cinvestav, Unidad Coapa, Calz. De los Tenorios 235, Col. Granjas Coapa, 14330 Mexico City, Mexico; Dirección de Investigaciones en Neurociencias, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Calz. México-Xochimilco 101, Col. San Lorenzo, Huipulco, 14370 Mexico City, Mexico
| | - Yarim Elideth De la Luz-Cuellar
- Departamento de Farmacobiología, Cinvestav, Unidad Coapa, Calz. De los Tenorios 235, Col. Granjas Coapa, 14330 Mexico City, Mexico
| | - Vinicio Granados-Soto
- Departamento de Farmacobiología, Cinvestav, Unidad Coapa, Calz. De los Tenorios 235, Col. Granjas Coapa, 14330 Mexico City, Mexico
| | - María Eva González-Trujano
- Dirección de Investigaciones en Neurociencias, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Calz. México-Xochimilco 101, Col. San Lorenzo, Huipulco, 14370 Mexico City, Mexico
| | - Alonso Fernández-Guasti
- Departamento de Farmacobiología, Cinvestav, Unidad Coapa, Calz. De los Tenorios 235, Col. Granjas Coapa, 14330 Mexico City, Mexico.
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Abstract
Environmental medical syndromes comprise sick building syndrome (SBS), multiple chemical sensitivity (MCS)/idiopathic environmental intolerances (IEI), electromagnetic hypersensitivity, chronic fatigue syndrome (CFS), burnout, fibromyalgia, and the candida syndrome. There is also some overlap described in the literature. There is still no established knowledge of etiology, pathology, pathophysiology, diagnostics, therapy, prevention and prognosis. These syndromes are thought to result from a complex interaction of physical, chemical and/or (micro)biological environmental stresses, individual dispositions, psychological influencing factors, perceptual and processing processes, variants of somatization disorders, culturally or socially caused distress, or simply iatrogenic causation. Examination and treatment methods must be developed or existing ones scientifically validated. However, all uncertainties in the assessment of these syndromes do not absolve the physician from taking patients seriously and helping them as best as possible.
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Thurm T, Ablin JN, Buskila D, Maharshak N. Fecal Microbiota Transplantation for Fibromyalgia: A Case Report and Review of the Literature. ACTA ACUST UNITED AC 2017. [DOI: 10.4236/ojgas.2017.74015] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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