Fibromyalgia is a disease, which is difficult to diagnose. These slides include ACR criteria 1990 and 2010 with Wide spread pain index(WPI) and Symptom severity score(SSS)
Fibromyalgia syndrome is a common and chronic disorder characterized
by widespread pain, diffuse tenderness, and a number of other symptoms.
The word “fibromyalgia” comes from the Latin term for fibrous tissue (fibro) and the Greek ones for muscle (myo) and pain (algia).
Although fibromyalgia is often considered an arthritis-related
condition, it is not truly a form of arthritis (a disease of the joints)
because it does not cause inflammation or damage to the joints,
muscles, or other tissues. Like arthritis, however, fibromyalgia can
cause significant pain and fatigue, and it can interfere with a person’s
ability to carry on daily activities. Also like arthritis, fibromyalgia
is considered a rheumatic condition, a medical condition that impairs
the joints and/or soft tissues and causes chronic pain.
In addition to pain and fatigue, people who have fibromyalgia may experience a variety of other symptoms including:
-- cognitive and memory problems (sometimes referred to as “fibro fog”)
-- sleep disturbances
-- morning stiffness
-- headaches
-- irritable bowel syndrome
-- painful menstrual periods
-- numbness or tingling of the extremities
-- restless legs syndrome
-- temperature sensitivity
-- sensitivity to loud noises or bright lights.
Fibromyalgia is a syndrome rather than a disease. A syndrome is a
collection of signs, symptoms, and medical problems that tend to occur
together but are not related to a specific, identifiable cause. A
disease, on the other hand, has a specific cause or causes and
recognizable signs and symptoms.
A person may have two or more coexisting chronic pain conditions.
Such conditions can include chronic fatigue syndrome, endometriosis,
fibromyalgia, inflammatory bowel disease, interstitial cystitis,
temporomandibular joint dysfunction, and vulvodynia. It is not known
whether these disorders share a common cause.
Fibromyalgia syndrome is a common and chronic disorder characterized
by widespread pain, diffuse tenderness, and a number of other symptoms.
The word “fibromyalgia” comes from the Latin term for fibrous tissue (fibro) and the Greek ones for muscle (myo) and pain (algia).
Although fibromyalgia is often considered an arthritis-related
condition, it is not truly a form of arthritis (a disease of the joints)
because it does not cause inflammation or damage to the joints,
muscles, or other tissues. Like arthritis, however, fibromyalgia can
cause significant pain and fatigue, and it can interfere with a person’s
ability to carry on daily activities. Also like arthritis, fibromyalgia
is considered a rheumatic condition, a medical condition that impairs
the joints and/or soft tissues and causes chronic pain.
In addition to pain and fatigue, people who have fibromyalgia may experience a variety of other symptoms including:
-- cognitive and memory problems (sometimes referred to as “fibro fog”)
-- sleep disturbances
-- morning stiffness
-- headaches
-- irritable bowel syndrome
-- painful menstrual periods
-- numbness or tingling of the extremities
-- restless legs syndrome
-- temperature sensitivity
-- sensitivity to loud noises or bright lights.
Fibromyalgia is a syndrome rather than a disease. A syndrome is a
collection of signs, symptoms, and medical problems that tend to occur
together but are not related to a specific, identifiable cause. A
disease, on the other hand, has a specific cause or causes and
recognizable signs and symptoms.
A person may have two or more coexisting chronic pain conditions.
Such conditions can include chronic fatigue syndrome, endometriosis,
fibromyalgia, inflammatory bowel disease, interstitial cystitis,
temporomandibular joint dysfunction, and vulvodynia. It is not known
whether these disorders share a common cause.
Still's disease, sometimes referred to as Adult-onset Still's disease (AOSD) is a rare systemic inflammatory disease characterized by the classic triad of persistent high spiking fevers, joint pain and a distinctive salmon-colored bumpy rash.
ME/CFS and FM present as complicated illnesses and getting the right diagnosis can be challenging or seem like an impossibility. Learn how to distinguish between these two diseases and recognize other conditions that may play a role in illness presentation.
Compassionate patient care is at the heart of what we do.
We set the standard for excellence in patient care through early diagnosis and evidence-based precision medicine. We reject the current healthcare system’s model of 10 minute visits. That doesn’t work for our patients. Our patient care is methodical, in-depth and allows us to really understand an individual and their illness.
We are a 501 c(3) dedicated to improving the lives of those that suffer from these devastating diseases.
Visit Batemanhornecenter.org to learn more.
ME/CFS and FM present as complicated illnesses and getting the right diagnosis can be challenging or seem like an impossibility. Learn how to distinguish between these two diseases and recognize other conditions that may play a role in illness presentation.
Compassionate patient care is at the heart of what we do
We set the standard for excellence in patient care through early diagnosis and evidence-based precision medicine. We reject the current healthcare system’s model of 10 minute visits. That doesn’t work for our patients. Our patient care is methodical, in-depth and allows us to really understand an individual and their illness.
We are a 501 c(3) dedicated to improving the lives of those that suffer from these devastating diseases.
Visit Batemanhornecenter.org to learn more.
Still's disease, sometimes referred to as Adult-onset Still's disease (AOSD) is a rare systemic inflammatory disease characterized by the classic triad of persistent high spiking fevers, joint pain and a distinctive salmon-colored bumpy rash.
ME/CFS and FM present as complicated illnesses and getting the right diagnosis can be challenging or seem like an impossibility. Learn how to distinguish between these two diseases and recognize other conditions that may play a role in illness presentation.
Compassionate patient care is at the heart of what we do.
We set the standard for excellence in patient care through early diagnosis and evidence-based precision medicine. We reject the current healthcare system’s model of 10 minute visits. That doesn’t work for our patients. Our patient care is methodical, in-depth and allows us to really understand an individual and their illness.
We are a 501 c(3) dedicated to improving the lives of those that suffer from these devastating diseases.
Visit Batemanhornecenter.org to learn more.
ME/CFS and FM present as complicated illnesses and getting the right diagnosis can be challenging or seem like an impossibility. Learn how to distinguish between these two diseases and recognize other conditions that may play a role in illness presentation.
Compassionate patient care is at the heart of what we do
We set the standard for excellence in patient care through early diagnosis and evidence-based precision medicine. We reject the current healthcare system’s model of 10 minute visits. That doesn’t work for our patients. Our patient care is methodical, in-depth and allows us to really understand an individual and their illness.
We are a 501 c(3) dedicated to improving the lives of those that suffer from these devastating diseases.
Visit Batemanhornecenter.org to learn more.
Fibromyalgia can be resolved by medical herbalismmorwenna2
A recent public awareness survey by the National Fibromyalgia Association illustrates a significant lack of understanding about Fibromyalgia: nearly half of the general public (45%) has never heard of Fibromyalgia, many people who are knowledgeable about the disorder incorrectly believe that nothing can be done to manage it, and nearly half (48%) of all healthcare providers are reluctant to diagnose a patient with the condition (National Fibromyalgia Association, 2007).
The evaluation of back pain can be a pain in the neck or a back-breaking exercise, so to speak. However, the diagnosis hinges always on a focused History and Physical Exam and not really on labs or imaging. Knowing what to ask and where to look can make the evaluation of this all-too-common condition manageable for the internist.
This lecture focuses on the evaluation of low back pain and will guide the reader on the key points in the Hx and PE and prevent unnecessary testing/imaging. It also presents 3 "unusual" cases of low back pain which may be disabling if not recognized immediately.
Musculoskeletal Health Concerns of the Aging PopulationAllan Corpuz
A lecture on low back pain, osteoarthritis and soft tissue rheumatisms delivered to nurses, nursing attendants and institutional workers at the the Philippine General Hospital
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
Anti ulcer drugs and their Advance pharmacology ||
Anti-ulcer drugs are medications used to prevent and treat ulcers in the stomach and upper part of the small intestine (duodenal ulcers). These ulcers are often caused by an imbalance between stomach acid and the mucosal lining, which protects the stomach lining.
||Scope: Overview of various classes of anti-ulcer drugs, their mechanisms of action, indications, side effects, and clinical considerations.
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Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
2. Introduction
Characterized by chronic widespread
musculoskeletal pain associated with considerable
distress, generalized fatigue, disturbance of sleep,
anxiety and depression.
Also known asNeurastheniaor fibrositis
09/05/16 2
3. FM leads to significant decreased function
and work capacity and the quality of life is
seriously affected
Although defined primarily as pain
syndromes there are associated
neuropsychological symptoms
09/05/16 3
4. Epidemiology
Prevalence rate of 2-3%
Fibromyalgia affects predominantly women in a ratio
of 9:1 compared to men
Most patients present with fibromyalgia between the
ages of 30–50 years
This disorder is found in most countries, in most
ethnic groups, and in all types of climate
09/05/16 4
5. Proposed etiology of
Fibromyalgia
Emerging evidence of genetic component of FM
- Specific gene mutations may predispose individuals to
FM
- Polymorphism in Catechol O-methyl
transferase(COMT) enzyme gene and serotonin transporter
are potentially associated with FM
09/05/16 5
6. Environmental factors that may trigger the onset of
FM
- Physical trauma and injury
- Infections (hepatitis C, lyme’s disease)
- Psychological stressor
FM may occur concurrently with arthritis (OA),
autoimmune diseases (RA,SLE)
09/05/16 6
9. Wind Up
• Drs. Price and Staud have demonstrated that
increasing repetitive nociceptive stimuli will activate
a wide range of dorsal horn neuronal pain discharges
in the CNS called “wind up”
• Temporal summation of pain on repetitive stimulation
of peripheral nociceptive afferents
Price, D and Staud, R, J Rheumatol 2005:32(75):22-28
09/05/16 9
10. • “Wind up” involves recruitment of NMDA pain
receptors in the CNS and neural plasticity of
nociceptive spinal cord pathway in central
sensitization
09/05/16 10
11. Central sensitization of FM
patients
• Increased levels of excitatory neuro-transmitters
glutamate and substance P
• Compared with normal controls, CSF levels of
substance P are 3-fold higher in FM patients
• There are decreased levels of serotonin and
norepinephrine which are needed for pain modulation
09/05/16 11
12. Neurotransmitters
◦ Substance P, an excitatory neurotransmitter which is
elevated in CSF of FM patients compared with
controls
◦ Glutamate acting at the A and C ascending pain fibersᶞ
1. Russell IJ, et al. Arthritis Rheum. 1994;37:1593-1601. 4. Russell IJ, et al. J Rheumatol. 1992;19:104-109.
2. Vaerøy H et al., Pain. 1988. 32:21-26. 5. Russell IJ, et al. Arthritis Rheum. 1992;35:550-556.
3. Watkins LR, et al. Brain Res. 1994;664:17-24. 6. Fields HL, et al. Annu Rev Neurosci. 1991;14:219-
245.
09/05/16 12
13. Serotonin and Norepinephrine
• Serotonin and norepinephrine mediate pain
modulation through the descending inhibitory pain
pathways in the brain and dorsal horn of the spinal
cord
• Dysfunction in fibromyalgia
09/05/16 13
14. Clinical features
Pain and tenderness
“ Pain all over” typically above and below the waist
on both sides and involves the axial skeleton
Neuropshychological symptoms
Fatigue, sleep disturbance, cognitive dysfunction,
anxiety and depression
09/05/16 14
15. Overlapping syndromes-
Can overlap in presentation with other chronic
conditions
Comorbid conditions-
Often associated with chronic musculoskeletal,
infectious, metabolic or psychiatric conditions
Functional impairment
09/05/16 15
18. Diagnostic criteria
The American College of Rheumatology 1990:
(1) A history of widespread pain for 3 month or
more
(2) Pain in at least 11 of 18 defined tender point
sites on digital palpation with a force of 4 kg with
thumb
09/05/16 18
20. Widespread Pain Index (WPI)
Pain in any of the ff areas in the last 7 days
• R/L Jaw
• Neck
• R/L Shoulder
• R/L Upper Arm
• R/L Forearm
• Upper Back
• Chest
• Abdomen
• Lower Back
• R/L Hip
• R/L Thighs
• R/L Calves
09/05/16 20
21. Symptom Severity Score
Somatic Symptoms – Have you had any of the following in the
last 6 months
• Blurred vision
• Tinnitus
• Mouth sores
• Dry mouth
• Headache
• Dizziness
• Fever
• Chest pains
• Dyspnea
• Wheezing
• Anorexia
• Nausea
• Diarrhea
• Constipation
• Itching
• Vomiting
• Easy bruising
• Hair loss
09/05/16 21
22. • WPI >7 and SS Score > 5
• WPI 3-6 and SS Score > 9
• Symptoms present for at least 3 months
09/05/16 22
23. a. Pain in the right side of the body
b.Pain in the left side of the body
c. Pain above the waist
d. Pain below the waist
e. Trunk and extremities
09/05/16 23
24. Sites for control points
• Mid forehead
• Junction of proximal 2/3rd
and Distal 1/3rd
of forearm
• Thumbnail
09/05/16 24
25. Sites for elicitation of tender
points
Pain on digital palpation in at least 11 of the following
18 tender point sites
a. Occiput: bilateral, at the suboccipital muscle
insertion
b. Low cervical: bilateral, at the anterior aspect of the
intertransverse spaces at C5–7
c. Trapezius: bilateral, at the midpoint of the upper
border
09/05/16 25
26. d. Supraspinatus: bilateral, at the origin, above the
scapular spine near the medial border
e. Second rib: bilateral, at the second costochondral
junction, just lateral to the junction on the upper
surface
f. Lateral epicondyle: bilateral, 2 cm distal to the
epicondyle
09/05/16 26
27. • g.Gluteal: bilateral, in the upper outer quadrant of the
buttock
• h.Greater trochanter: bilateral, posterior to the
trochanteric prominence
• i.Knee: bilateral, at the medial fat pad proximal to
the joint line
09/05/16 27
35. Non pharmacological treatment
1.Self-management strategies
- Education and active participation with reassurance
2. Multi component therapy
- Comprise of one educational or other psychological
therapy and at least one exercise therapy
09/05/16 35
36. Rehabilitation of FM
Pain reduction modalities
•Cryotherapy
•Therapeutic heat
•Administration of local anesthetics
09/05/16 36
37. Aerobic and flexibility exercise
• Exercise can activate endogenous opioids and reduce
“wind up”
• Low level of exercise
• Progress slowly
09/05/16 37
38. • Begin with gentle warm up
• Low impact aerobic exercise for atleast 3 time wkly
• Target exercise regimen- 4 to 5 times a wk for at least
20-30 minutes every session
09/05/16 38
