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[PMID]:29406043
[Au] Autor:Tzeng NS; Chung CH; Liu FC; Chiu YH; Chang HA; Yeh CB; Huang SY; Lu RB; Yeh HW; Kao YC; Chiang WS; Tsao CH; Wu YF; Chou YC; Lin FH; Chien WC
[Ad] Endereço:Department of Psychiatry, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan, ROC; Student Counseling Center, National Defense Medical Center, Taipei, Taiwan, ROC.
[Ti] Título:Fibromyalgia and Risk of Dementia-A Nationwide, Population-Based, Cohort Study.
[So] Source:Am J Med Sci;355(2):153-161, 2018 02.
[Is] ISSN:1538-2990
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Fibromyalgia is a syndrome of chronic pain and other symptoms and is associated with patient discomfort and other diseases. This nationwide matched-cohort population-based study aimed to investigate the association between fibromyalgia and the risk of developing dementia, and to clarify the association between fibromyalgia and dementia. MATERIALS AND METHODS: A total of 41,612 patients of age ≥50 years with newly diagnosed fibromyalgia between January 1, and December 31, 2000 were selected from the National Health Insurance Research Database of Taiwan, along with 124,836 controls matched for sex and age. After adjusting for any confounding factors, Fine and Gray competing risk analysis was used to compare the risk of developing dementia during the 10 years of follow-up. RESULTS: Of the study subjects, 1,704 from 41,612 fibromyalgia patients (21.23 per 1,000 person-years) developed dementia when compared to 4,419 from 124,836 controls (18.94 per 1,000 person-years). Fine and Gray competing risk analysis revealed that the study subjects were more likely to develop dementia (hazard ratio: 2.29, 95% CI: 2.16-2.42; P < 0.001). After adjusting for sex, age, monthly income, urbanization level, geographic region of residence and comorbidities the hazard ratio was 2.77 (95% CI: 2.61-2.95, P < 0.001). Fibromyalgia was associated with increased risk of all types of dementia in this study. CONCLUSIONS: The study subjects with fibromyalgia had a 2.77-fold risk of dementia in comparison to the control group. Therefore, further studies are needed to elucidate the underlying mechanisms of the association between fibromyalgia and the risk of dementia.
[Mh] Termos MeSH primário: Bases de Dados Factuais
Demência/epidemiologia
Demência/etiologia
Fibromialgia/complicações
Fibromialgia/epidemiologia
[Mh] Termos MeSH secundário: Fatores Etários
Idoso
Idoso de 80 Anos ou mais
Demência/fisiopatologia
Feminino
Fibromialgia/fisiopatologia
Seguimentos
Seres Humanos
Masculino
Meia-Idade
Fatores de Risco
Fatores Sexuais
Fatores Socioeconômicos
Taiwan/epidemiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180301
[Lr] Data última revisão:
180301
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180207
[St] Status:MEDLINE


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[PMID]:29281686
[Au] Autor:Beshai S; Mishra S; Mishra S; Carleton RN
[Ad] Endereço:Department of Psychology, University of Regina, Regina, SK, Canada.
[Ti] Título:Personal relative deprivation associated with functional disorders via stress: An examination of fibromyalgia and gastrointestinal symptoms.
[So] Source:PLoS One;12(12):e0189666, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Personal relative deprivation is a negative social comparison process typified by self-comparison, negative appraisal, and resultant negative emotionality. Personal relative deprivation has been associated with poorer physical and mental health in several domains. It has been hypothesized that the deprivation-health link operates through a stress pathway. Stress has been specifically implicated in the onset and maintenance of functional disorders, including fibromyalgia and functional gastrointestinal disorders. Despite the theoretical links between personal deprivation, stress, and functional disorders, researchers have not assessed relationships between these variables. METHODS: We recruited community participants (n = 517; 54.9% female) to examine whether personal relative deprivation can account for variance in fibromyalgia and functional gastrointestinal symptoms beyond known demographic correlates of physical health. We also examined whether the relationships between personal relative deprivation and functional disorder symptoms are mediated by stress. RESULTS: Consistent with our hypotheses, personal relative deprivation accounted for symptom variance in fibromyalgia and functional gastrointestinal disorders beyond that accounted for by demographic variables alone. Further, self-reported stress was found to mediate relationships between personal relative deprivation and fibromyalgia and gastrointestinal symptoms. CONCLUSIONS: The current results support biopsychosocial models of physical health and suggest that, for patients presenting with functional disorders symptoms, a combination of biological and psychosocial interventions may be warranted.
[Mh] Termos MeSH primário: Fibromialgia/psicologia
Gastroenteropatias/psicologia
Estresse Psicológico/psicologia
[Mh] Termos MeSH secundário: Adulto
Feminino
Seres Humanos
Masculino
Meia-Idade
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180129
[Lr] Data última revisão:
180129
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171228
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0189666


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[PMID]:29256764
[Au] Autor:Clauw DJ; D'Arcy Y; Gebke K; Semel D; Pauer L; Jones KD
[Ad] Endereço:a Department of Anesthesiology , University of Michigan , Ann Arbor , MI , USA.
[Ti] Título:Normalizing fibromyalgia as a chronic illness.
[So] Source:Postgrad Med;130(1):9-18, 2018 Jan.
[Is] ISSN:1941-9260
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Fibromyalgia (FM) is a complex chronic disease that affects 3-10% of the general adult population and is principally characterized by widespread pain, and is often associated with disrupted sleep, fatigue, and comorbidities, among other symptoms. There are many gaps in our knowledge of FM, such that, compared with other chronic illnesses including diabetes, rheumatoid arthritis, and asthma, it is far behind in terms of provider understanding and therapeutic approaches. The experience that healthcare professionals (HCPs) historically gained in developing approaches to manage and treat patients with these chronic illnesses may help show how they can address similar problems in patients with FM. In this review, we examine some of the issues around the management and treatment of FM, and discuss how HCPs can implement appropriate strategies for the benefit of patients with FM. These issues include understanding that FM is a legitimate condition, the benefits of prompt diagnosis, use of non-drug and pharmacotherapies, patient and HCP education, watchful waiting, and assessing patients by FM domain so as not to focus exclusively on one symptom to the detriment of others. Developing successful approaches is of particular importance for HCPs in the primary care setting who are in the ideal position to provide long-term care for patients with FM. In this way, FM may be normalized as a chronic illness to the benefit of both patients and HCPs.
[Mh] Termos MeSH primário: Fibromialgia/diagnóstico
Fibromialgia/terapia
[Mh] Termos MeSH secundário: Doença Crônica
Fibromialgia/complicações
Seres Humanos
Educação de Pacientes como Assunto
Conduta Expectante
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180103
[Lr] Data última revisão:
180103
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171220
[St] Status:MEDLINE
[do] DOI:10.1080/00325481.2018.1411743


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[PMID]:27773810
[Au] Autor:Geller EJ; Babb E; Nackley AG; Zolnoun D
[Ad] Endereço:Division of Female Pelvic Medicine and Reconstructive Surgery, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina. Electronic address: egeller@med.unc.edu.
[Ti] Título:Incidence and Risk Factors for Pelvic Pain After Mesh Implant Surgery for the Treatment of Pelvic Floor Disorders.
[So] Source:J Minim Invasive Gynecol;24(1):67-73, 2017 Jan 01.
[Is] ISSN:1553-4669
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:STUDY OBJECTIVE: Our aim was to assess incidence and risk factors for pelvic pain after pelvic mesh implantation. DESIGN: Retrospective study (Canadian Task Force classification II-2). SETTING: Single university hospital. PATIENTS: Women who have undergone surgery with pelvic mesh implant for treatment of pelvic floor disorders including prolapse and incontinence. INTERVENTIONS: Telephone interviews to assess pain, sexual function, and general health. MEASUREMENTS AND MAIN RESULTS: Pain was measured by the McGill Short-Form Pain Questionnaire for somatic pain, Neuropathic Pain Symptom Inventory for neuropathic pain, Pennebaker Inventory of Limbic Languidness for somatization, and Female Sexual Function Index (FSFI) for sexual health and dyspareunia. General health was assessed with the 12-item Short-Form Health Survey. Among 160 enrolled women, mean time since surgery was 20.8 ± 10.5 months, mean age was 62.1 ± 11.2 years, 93.8% were white, 86.3% were postmenopausal, and 3.1% were tobacco users. Types of mesh included midurethral sling for stress incontinence (78.8%), abdominal/robotic sacrocolpopexy (35.7%), transvaginal for prolapse (6.3%), and perirectal for fecal incontinence (1.9%), with 23.8% concomitant mesh implants for both prolapse and incontinence. Our main outcome, self-reported pelvic pain at least 1 year after surgery, was 15.6%. Women reporting pain were younger, with fibromyalgia, worse physical health, higher somatization, and lower surgery satisfaction (all p < .05). Current pelvic pain correlated with early postoperative pelvic pain (p < .001), fibromyalgia (p = .002), worse physical health (p = .003), and somatization (p = .003). Sexual function was suboptimal (mean FSFI, 16.2 ± 12.1). Only 54.0% were sexually active, with 19.0% of those reporting dyspareunia. CONCLUSION: One in 6 women reported de novo pelvic pain after pelvic mesh implant surgery, with decreased sexual function. Risk factors included younger age, fibromyalgia, early postoperative pain, poorer physical health, and somatization. Understanding risk factors for pelvic pain after mesh implantation may improve patient selection.
[Mh] Termos MeSH primário: Distúrbios do Assoalho Pélvico/cirurgia
Dor Pélvica/etiologia
Telas Cirúrgicas
[Mh] Termos MeSH secundário: Fatores Etários
Feminino
Fibromialgia/complicações
Nível de Saúde
Seres Humanos
Incidência
Meia-Idade
Complicações Pós-Operatórias
Estudos Retrospectivos
Fatores de Risco
Transtornos Somatoformes/complicações
Slings Suburetrais
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1707
[Cu] Atualização por classe:180101
[Lr] Data última revisão:
180101
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161025
[St] Status:MEDLINE


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[PMID]:29069023
[Au] Autor:Collado-Mateo D; Domínguez-Muñoz FJ; Olivares PR; Adsuar JC; Gusi N
[Ad] Endereço:aFaculty of Sport Science, University of Extremadura, Spain bFacultad de Educación, Universidad Autónoma de Chile, Talca, Chile.
[Ti] Título:Stair negotiation in women with fibromyalgia: A descriptive correlational study.
[So] Source:Medicine (Baltimore);96(43):e8364, 2017 Oct.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Walking up and down stairs is a common and important activity of daily living. Women with fibromyalgia often show a reduced ability to perform this task.The objective of this study was to evaluate the test-retest reliability of stair negotiation tasks and to assess the impact of fibromyalgia symptoms on the ability to negotiate stairs.Forty-two women with fibromyalgia participated in this descriptive correlational study. The relevance of the stair negotiation (both walking up and down) was evaluated by assessing its association with the revised version of the fibromyalgia impact questionnaire (FIQ-R) and other health-related variables. Test-retest reliability was also analyzed. The main outcome measures were time spent walking up and down stairs and impact of fibromyalgia, quality of life, number of falls, weight, and lower limb strength and endurance.The intraclass correlation coefficient (ICC) for stair descent was 0.929 whereas that for ascent was 0.972. The score in these tests correlated significantly with the total score for the FIQ-R and the score for many of dimensions and symptoms: that is, physical function, overall impact of fibromyalgia, pain, energy, stiffness, restorative sleep, tenderness, self-perceived balance problems, and sensitivity.Given the importance of the stair negotiation as activity of daily living and the high reliability, both stair ascent and descent tasks may be useful as outcome measures in studies on patients with fibromyalgia.
[Mh] Termos MeSH primário: Atividades Cotidianas
Avaliação da Deficiência
Fibromialgia/fisiopatologia
Análise e Desempenho de Tarefas
Caminhada
[Mh] Termos MeSH secundário: Acidentes por Quedas/estatística & dados numéricos
Adulto
Idoso
Feminino
Seres Humanos
Extremidade Inferior/fisiopatologia
Meia-Idade
Qualidade de Vida
Reprodutibilidade dos Testes
Estatística como Assunto
Inquéritos e Questionários
[Pt] Tipo de publicação:EVALUATION STUDIES; JOURNAL ARTICLE
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171123
[Lr] Data última revisão:
171123
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171026
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000008364


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[PMID]:29045211
[Au] Autor:Palamara K; Nagarur A; Fintelmann FJ; Kohler MJ; Cortazar FB
[Ad] Endereço:From the Departments of Medicine (K.P., A.N., M.J.K., F.B.C.) and Radiology (F.J.F.), Massachusetts General Hospital, and the Departments of Medicine (K.P., A.N., M.J.K., F.B.C.) and Radiology (F.J.F.), Harvard Medical School - both in Boston.
[Ti] Título:Case 32-2017. A 64-Year-Old Man with Dyspnea, Wheezing, Headache, Cough, and Night Sweats.
[So] Source:N Engl J Med;377(16):1569-1578, 2017 10 19.
[Is] ISSN:1533-4406
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Anticorpos Anticitoplasma de Neutrófilos/sangue
Granulomatose com Poliangiite/diagnóstico
Peroxidase/imunologia
[Mh] Termos MeSH secundário: Tosse/etiologia
Diagnóstico Diferencial
Dispneia/etiologia
Eosinofilia/etiologia
Fibromialgia/complicações
Granulomatose com Poliangiite/complicações
Granulomatose com Poliangiite/tratamento farmacológico
Cefaleia/etiologia
Seres Humanos
Imunossupressores/uso terapêutico
Pulmão/diagnóstico por imagem
Pulmão/patologia
Masculino
Meia-Idade
Sons Respiratórios/etiologia
Sudorese
Tomografia Computadorizada por Raios X
[Pt] Tipo de publicação:CASE REPORTS; CLINICAL CONFERENCE; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antibodies, Antineutrophil Cytoplasmic); 0 (Immunosuppressive Agents); EC 1.11.1.7 (Peroxidase)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171026
[Lr] Data última revisão:
171026
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171019
[St] Status:MEDLINE
[do] DOI:10.1056/NEJMcpc1703513


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[PMID]:28968914
[Au] Autor:Estévez-López F; Segura-Jiménez V; Álvarez-Gallardo IC; Borges-Cosic M; Pulido-Martos M; Carbonell-Baeza A; Aparicio VA; Geenen R; Delgado-Fernández M
[Ad] Endereço:Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Granada, Spain.
[Ti] Título:Adaptation profiles comprising objective and subjective measures in fibromyalgia: the al-Ándalus project.
[So] Source:Rheumatology (Oxford);56(11):2015-2024, 2017 Nov 01.
[Is] ISSN:1462-0332
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Objectives: The aim of this study was to identify subgroups in terms of adaptation to FM and to test differences in FM severity between these subgroups. Methods: The al-Ándalus project made it possible to perform a comprehensive population-based cross-sectional study in 486 FM patients including multiple assessments of modifiable (could be targeted in therapy) resilience and vulnerability factors, measured by objective and subjective assessments, related to psychological and physical function. FM severity was assessed by means of FM impact (total score of the Revised Fibromyalgia Impact Questionnaire) and distress (Polysymptomatic Distress Scale of the modified 2011 preliminary criteria for FM). Exploratory factor analysis, cluster analysis and analysis of variance were conducted. Results: Factor analysis yielded eight factors: three included objective measures (declarative memory, active lifestyle and objective physical fitness) and five included subjective measures (fatigue, psychological distress, catastrophizing, resilience and subjective physical fitness). Cluster analysis based on these eight factors identified five profiles: Adapted (16%), Fit (18%), Poor performer (20%), Positive (20%) and Maladapted (26%). Most profile comparisons revealed different levels of FM severity varying from Adapted (the most favourable profile) to Maladapted (the most unfavourable profile) with Fit, Poor performer and Positive obtaining intermediate positions. Conclusions: Heterogeneity of FM was shown by five clinically meaningful profiles of modifiable factors that were associated with FM severity. It is of clinical interest to examine whether these profiles are associated with FM prognosis and the effectiveness of interventions, which would enhance the development of customized interventions based on adaptation profiles in FM.
[Mh] Termos MeSH primário: Atividades Cotidianas
Adaptação Psicológica
Fibromialgia/fisiopatologia
Fibromialgia/psicologia
Resiliência Psicológica
[Mh] Termos MeSH secundário: Adulto
Catastrofização/psicologia
Análise por Conglomerados
Estudos Transversais
Exercício/psicologia
Análise Fatorial
Fadiga/etiologia
Fadiga/fisiopatologia
Fadiga/psicologia
Feminino
Fibromialgia/complicações
Seres Humanos
Estilo de Vida
Masculino
Memória
Meia-Idade
Aptidão Física/psicologia
Índice de Gravidade de Doença
Espanha
Estresse Psicológico/psicologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171106
[Lr] Data última revisão:
171106
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171003
[St] Status:MEDLINE
[do] DOI:10.1093/rheumatology/kex302


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[PMID]:28779491
[Au] Autor:Cooper TE; Wiffen PJ; Heathcote LC; Clinch J; Howard R; Krane E; Lord SM; Sethna N; Schechter N; Wood C
[Ad] Endereço:Cochrane Pain, Palliative and Supportive Care Group, Pain Research Unit, Churchill Hospital, Churchill Hospital, Oxford, Oxfordshire, UK, OX3 7LE.
[Ti] Título:Antiepileptic drugs for chronic non-cancer pain in children and adolescents.
[So] Source:Cochrane Database Syst Rev;8:CD012536, 2017 08 05.
[Is] ISSN:1469-493X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Pain is a common feature of childhood and adolescence around the world, and for many young people, that pain is chronic. The World Health Organization (WHO) guidelines for pharmacological treatments for children's persisting pain acknowledge that pain in children is a major public health concern of high significance in most parts of the world. While in the past, pain was largely dismissed and was frequently left untreated, views on children's pain have changed over time, and relief of pain is now seen as importantWe designed a suite of seven reviews on chronic non-cancer pain and cancer pain (looking at antidepressants, antiepileptic drugs, non-steroidal anti-inflammatory drugs, opioids, and paracetamol) in order to review the evidence for children's pain utilising pharmacological interventions in children and adolescents.As the leading cause of morbidity in the world today, chronic disease (and its associated pain) is a major health concern. Chronic pain (that is pain lasting three months or longer) can occur in the paediatric population in a variety of pathophysiological classifications (nociceptive, neuropathic, or idiopathic) relating to genetic conditions, nerve damage pain, chronic musculoskeletal pain, and chronic abdominal pain, and for other unknown reasons.Antiepileptic (anticonvulsant) drugs, which were originally developed to treat convulsions in people with epilepsy, have in recent years been used to provide pain relief in adults for many chronic painful conditions and are now recommended for the treatment of chronic pain in the WHO list of essential medicines. Known side effects of antiepileptic drugs range from sweating, headache, elevated temperature, nausea, and abdominal pain to more serious effects including mental or motor function impairment. OBJECTIVES: To assess the analgesic efficacy and adverse events of antiepileptic drugs used to treat chronic non-cancer pain in children and adolescents aged between birth and 17 years, in any setting. SEARCH METHODS: We searched the Cochrane Central Register of Controlled Trials (CENTRAL) via the Cochrane Register of Studies Online, MEDLINE via Ovid, and Embase via Ovid from inception to 6 September 2016. We also searched the reference lists of retrieved studies and reviews as well as online clinical trial registries. SELECTION CRITERIA: Randomised controlled trials, with or without blinding, by any route, treating chronic non-cancer pain in children and adolescents, comparing any antiepileptic drug with placebo or an active comparator. DATA COLLECTION AND ANALYSIS: Two review authors independently assessed studies for eligibility. We planned to use dichotomous data to calculate risk ratio and number needed to treat for one additional event, using standard methods if data were available. We assessed the evidence using GRADE and created two 'Summary of findings' tables. MAIN RESULTS: We included two studies with a total of 141 participants (aged 7 to 18 years) with chronic neuropathic pain, complex regional pain syndrome type 1 (CRPS-I), or fibromyalgia. One study investigated pregabalin versus placebo in participants with fibromyalgia (107 participants), and the other study investigated gabapentin versus amitriptyline in participants with CRPS-I or neuropathic pain (34 participants). We were unable to perform any quantitative analysis.Risk of bias for the two included studies varied, due to issues with randomisation (low to unclear risk), blinding of outcome assessors (low to unclear risk), reporting bias (low to unclear risk), the size of the study populations (high risk), and industry funding in the 'other' domain (low to unclear risk). We judged the remaining domains of sequence generation, blinding of participants and personnel, and attrition as low risk of bias. Primary outcomesOne study (gabapentin 900 mg/day versus amitriptyline 10 mg/day, 34 participants, for 6 weeks) did not report our primary outcomes (very low-quality evidence).The second study (pregabalin 75 to 450 mg/day versus placebo 75 to 450 mg/day, 107 participants, for 15 weeks) reported no significant change in pain scores for pain relief of 30% or greater between pregabalin 18/54 (33.3%), and placebo 16/51 (31.4%), P = 0.83 (very low-quality evidence). This study also reported Patient Global Impression of Change, with the percentage of participants feeling "much or very much improved" with pregabalin 53.1%, and placebo 29.5% (very low-quality evidence).We downgraded the evidence by three levels to very low for one of two reasons: due to the fact that there was no evidence to support or refute the use of the intervention, or that there were too few data and the number of events was too small to be meaningful. Secondary outcomesIn one small study, adverse events were uncommon: gabapentin 2 participants (2 adverse events); amitriptyline 1 participant (1 adverse event) (6-week trial). The second study reported a higher number of adverse events: pregabalin 38 participants (167 adverse events); placebo 34 participants (132 adverse events) (15-week trial) (very low-quality evidence).Withdrawals due to adverse events were infrequent in both studies: pregabalin (4 participants), placebo (4 participants), gabapentin (2 participants), and amitriptyline (1 participant) (very low-quality evidence).Serious adverse events were reported in both studies. One study reported only one serious adverse event (cholelithiasis and major depression resulting in hospitalisation in the pregabalin group) and the other study reported no serious adverse events (very low-quality evidence).There were few or no data for our remaining secondary outcomes (very low-quality evidence).We downgraded the evidence by three levels to very low due to too few data and the fact that the number of events was too small to be meaningful. AUTHORS' CONCLUSIONS: This review identified only two small studies, with insufficient data for analysis.As we could undertake no meta-analysis, we were unable to comment about efficacy or harm from the use of antiepileptic drugs to treat chronic non-cancer pain in children and adolescents. Similarly, we could not comment on our remaining secondary outcomes: Carer Global Impression of Change; requirement for rescue analgesia; sleep duration and quality; acceptability of treatment; physical functioning; and quality of life.We know from adult randomised controlled trials that some antiepileptics, such as gabapentin and pregabalin, can be effective in certain chronic pain conditions.We found no evidence to support or refute the use of antiepileptic drugs to treat chronic non-cancer pain in children and adolescents.
[Mh] Termos MeSH primário: Aminas/uso terapêutico
Amitriptilina/uso terapêutico
Anticonvulsivantes/uso terapêutico
Dor Crônica/tratamento farmacológico
Síndromes da Dor Regional Complexa/tratamento farmacológico
Ácidos Cicloexanocarboxílicos/uso terapêutico
Fibromialgia/tratamento farmacológico
Neuralgia/tratamento farmacológico
Pregabalina/uso terapêutico
Ácido gama-Aminobutírico/uso terapêutico
[Mh] Termos MeSH secundário: Adolescente
Aminas/efeitos adversos
Amitriptilina/efeitos adversos
Anticonvulsivantes/efeitos adversos
Criança
Ácidos Cicloexanocarboxílicos/efeitos adversos
Seres Humanos
Pregabalina/efeitos adversos
Ensaios Clínicos Controlados Aleatórios como Assunto
Ácido gama-Aminobutírico/efeitos adversos
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T; REVIEW
[Nm] Nome de substância:
0 (Amines); 0 (Anticonvulsants); 0 (Cyclohexanecarboxylic Acids); 1806D8D52K (Amitriptyline); 55JG375S6M (Pregabalin); 56-12-2 (gamma-Aminobutyric Acid); 6CW7F3G59X (gabapentin)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170920
[Lr] Data última revisão:
170920
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170806
[St] Status:MEDLINE
[do] DOI:10.1002/14651858.CD012536.pub2


  9 / 7198 MEDLINE  
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[PMID]:28700720
[Au] Autor:Rodríguez A; Tembl J; Mesa-Gresa P; Muñoz MÁ; Montoya P; Rey B
[Ad] Endereço:Departamento de Ingeniería Gráfica, Universitat Politècnica de València, Camino de Vera s/n, Valencia, Spain.
[Ti] Título:Altered cerebral blood flow velocity features in fibromyalgia patients in resting-state conditions.
[So] Source:PLoS One;12(7):e0180253, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The aim of this study is to characterize in resting-state conditions the cerebral blood flow velocity (CBFV) signals of fibromyalgia patients. The anterior and middle cerebral arteries of both hemispheres from 15 women with fibromyalgia and 15 healthy women were monitored using Transcranial Doppler (TCD) during a 5-minute eyes-closed resting period. Several signal processing methods based on time, information theory, frequency and time-frequency analyses were used in order to extract different features to characterize the CBFV signals in the different vessels. Main results indicated that, in comparison with control subjects, fibromyalgia patients showed a higher complexity of the envelope CBFV and a different distribution of the power spectral density. In addition, it has been observed that complexity and spectral features show correlations with clinical pain parameters and emotional factors. The characterization features were used in a lineal model to discriminate between fibromyalgia patients and healthy controls, providing a high accuracy. These findings indicate that CBFV signals, specifically their complexity and spectral characteristics, contain information that may be relevant for the assessment of fibromyalgia patients in resting-state conditions.
[Mh] Termos MeSH primário: Circulação Cerebrovascular
Fibromialgia/fisiopatologia
[Mh] Termos MeSH secundário: Adulto
Afeto
Idoso
Velocidade do Fluxo Sanguíneo
Estudos de Casos e Controles
Feminino
Fibromialgia/diagnóstico por imagem
Seres Humanos
Meia-Idade
Artéria Cerebral Média/diagnóstico por imagem
Artéria Cerebral Média/fisiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170926
[Lr] Data última revisão:
170926
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170713
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0180253


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[PMID]:28686639
[Au] Autor:Rifbjerg-Madsen S; Christensen AW; Christensen R; Hetland ML; Bliddal H; Kristensen LE; Danneskiold-Samsøe B; Amris K
[Ad] Endereço:The Parker Institute, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Frederiksberg, Denmark.
[Ti] Título:Pain and pain mechanisms in patients with inflammatory arthritis: A Danish nationwide cross-sectional DANBIO registry survey.
[So] Source:PLoS One;12(7):e0180014, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Central pain mechanisms may be prominent in subsets of patients with rheumatoid arthritis (RA), psoriatic arthritis (PsA) and other spondyloarthritis (SpA). The painDETECT questionnaire (PDQ) identifies neuropathic pain features, which may act as a proxy for centrally mediated pain. The objectives were to quantify and characterize pain phenotypes (non-neuropathic vs. neuropathic features) among Danish arthritis patients using the PDQ, and to assess the association with on-going inflammation. METHODS: The PDQ was included onto the DANBIO touch screens at 22 departments of Rheumatology in Denmark for six months. Clinical data and patient reported outcomes were obtained from DANBIO. A PDQ-score >18 indicated neuropathic pain features, 13-18 unclear pain mechanism and <13 non-neuropathic pain. RESULTS: Pain data (visual analogue scale, VAS) was available for 15,978 patients. 7,054 patients completed the PDQ (RA: 3,826, PsA: 1,180, SpA: 1,093). 52% of all patients and 63% of PDQ-completers had VAS pain score ≥ 30 mm. The distribution of the PDQ classification-groups (<13/ 13-18/ >18) were; RA: 56%/24%/20%. PsA: 45%/ 27%/ 28%. SpA: 55% / 24%/ 21%. More patients with PsA had PDQ score >18 compared to RA and SpA (p<0.001). For PDQ > 18 significantly higher scores were found for all patient reported outcomes and disease activity scores. No clinical difference in CRP or swollen joint count was found. Logistic regression showed increased odds for having VAS pain ≥39 mm (the median) for a PDQ-score >18 compared to <13 (OR = 10.4; 95%CI 8.6-12.5). CONCLUSIONS: More than 50% of the Danish arthritis patients reported clinically significant pain. More than 20% of the PDQ-completers had indication of neuropathic pain features, which was related to a high pain-level. PDQ-score was associated with DAS28-CRP and VAS pain but not with indicators of peripheral inflammation (CRP and SJC). Thus, pain classification by PDQ may assist in mechanism-based pain treatment.
[Mh] Termos MeSH primário: Artrite Psoriásica/fisiopatologia
Artrite Reumatoide/fisiopatologia
Inflamação/fisiopatologia
Dor/fisiopatologia
[Mh] Termos MeSH secundário: Adulto
Idoso
Antirreumáticos/uso terapêutico
Artrite Psoriásica/complicações
Artrite Psoriásica/tratamento farmacológico
Artrite Psoriásica/epidemiologia
Artrite Reumatoide/complicações
Artrite Reumatoide/tratamento farmacológico
Artrite Reumatoide/epidemiologia
Dinamarca
Feminino
Fibromialgia/complicações
Fibromialgia/tratamento farmacológico
Fibromialgia/epidemiologia
Fibromialgia/fisiopatologia
Seres Humanos
Inflamação/complicações
Inflamação/tratamento farmacológico
Inflamação/epidemiologia
Masculino
Meia-Idade
Neuralgia/complicações
Neuralgia/tratamento farmacológico
Neuralgia/epidemiologia
Neuralgia/fisiopatologia
Dor/complicações
Dor/tratamento farmacológico
Dor/epidemiologia
Medição da Dor
Índice de Gravidade de Doença
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antirheumatic Agents)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171004
[Lr] Data última revisão:
171004
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170708
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0180014



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