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Tuesday, 26 November 2013

Fibromyalgia – The Complications

Fibromyalgia, according to the American College of Rheumatology 1990 Criteria for the Classification of Fibromyalgia in the newly proposed criteria for the classification of fibromyalgia are 1) widespread pain in combination with 2) tenderness at 11 or more of the 18 specific tender point sites(a) as a result in responding to pressure.
III. Complications
1. Negative impact in relationships
In a study was designed to survey a large community sample of adults with fibromyalgia about the impact on the spouse/partner, children and close friends, found that in addition to physical impairments that are well documented among individuals with fibromyalgia, fibromyalgia can result in a substantial negative impact on important relationships with family and close friends(13).
2. Psychological problem
According to the study by Monash University and Monash Medical Centre in comparison between FM patients and healthy individuals found significant differences in control (Perceived Control of Internal States Scale and Mastery Scale), pain, perceived stress, fatigue, confusion, and mood disturbance (all P < 0.001). There were significant associations found between both high and low levels of control on stress, mood, pain, and fatigue (P < 0.001-0.05). Strong negative correlations were present between internal control and perceived stress (P < 0.0005)(14).
3. Pain disability, depression, and pressure sensitivity differences in genders
In the study to determine the differences in pain, disability, depression, and pressure sensitivity between men and women with fibromyalgia syndrome (FMS), and to analyze the relationship between pain and pressure sensitivity in FMS, found that w determine the differences in pain, disability, depression, and pressure sensitivity between men and women with fibromyalgia syndrome (FMS), and to analyze the relationship between pain and pressure sensitivity in FMS(15).
4. Impaired functionality, and impact on the quality of life
In the study to compare depressive symptoms and stress perception between women with and without FM, in addition to investigate the relationship between those characteristics and the functionality and the impact on the quality of life of those patients, showed that in the FM group, a positive correlation was observed between the depressive symptoms and perceived stress (r = 0.54, P < 0.05), pain (r = 0.58, P < 0.01), impaired functionality (r = 0.56, P < 0.01), and impact on the quality of life (r = 0.46, P < 0.05). In this group there was also correlation between perceived stress and impaired functionality (r = 0.50;P < 0.05). Pain showed no relationship with perceived stress(16).
5. Fall risk
There were significant relationships between fall risk and NRS scores (r = 0.565), and FIQ fatigue subscores (r = 0.560) (both p < 0.05). Worse postural performance and fall risk found in the fibromyalgia patients compared to controls were related with the sleep quality in the last 24 h and level of fatigue, according to the study by Pamukkale University Medical School(17).
6. Postural control deficits
In the study to determine whether FM patients, compared to age-matched healthy controls (HCs), have differences in dynamic posturography, including sensory, motor, and limits of stability, found that that middle-aged FM patients have consistent objective sensory deficits on dynamic posturography, despite having a normal clinical neurological examination. Further study is needed to determine prospective fall rates and the significance of lower-extremity MTPs. The development of interventions to improve balance and reduce falls in FM patients may need to combine balance training with exercise and cognitive training(18).
7.  Infections, neoplastic and cardiovascular disease and mortality
In the study to determine whether fibromyalgia (FM) is associated with an increase in comorbidity (infections, neoplastic and cardiovascular disease) as well as with an increase in mortality, showed that despite the high comorbidity and medical resource use in FM, there is no evidence that this entity is associated with an increase in comborbidity due to cardiovascular disease or infections. The association between FM and HIV and hepatitis C virus infections suggests a possible relationship between FM and chronic viral infection. Patients with chronic generalized pain may have an increased risk of developing cancer. FM may also carry an increased risk of accidental death and death from cancer(19).
8. Etc.
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Sources
(a) http://www.ncbi.nlm.nih.gov/pubmed/2306288
(13) http://www.ncbi.nlm.nih.gov/pubmed/23172797 
(14) http://www.ncbi.nlm.nih.gov/pubmed/23152697
(15) http://www.ncbi.nlm.nih.gov/pubmed/23171037
(16) http://www.ncbi.nlm.nih.gov/pubmed/22641587
(17) http://www.ncbi.nlm.nih.gov/pubmed/23179001
(18) http://www.ncbi.nlm.nih.gov/pubmed/21810264
(19) http://www.ncbi.nlm.nih.gov/pubmed/21794265