Wednesday, 25 May 2016

Most Common Disease of 50plus: The Clinical trials and Studies of Musculo-Skeletal disorders(MSDs) - Fibromyalgia - The Causes

Kyle J. Norton (Scholar)
Health article writer and researcher; Over 10.000 articles and research papers have been written and published on line, including world wide health, ezine articles, article base, healthblogs, selfgrowth, best before it's news, the karate GB daily, etc.,.
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Some articles have been used as references in medical research, such as international journal Pharma and Bio science, ISSN 0975-6299.

Musculoskeletal disorders (MSDs) are  medical condition mostly caused by work related occupations and working environment, affecting patients’ muscles, joints, tendons, ligaments and nerves and developing over time. A community sample of 73 females and 32 males aged 85 and over underwent a standardised examination at home. Musculoskeletal pain was reported by 57% of those interviewed(1).

      Types of Musculo-Skeletal disorders in elder

1. Osteoarthritis
2. Gout
3. Rheumatoid Arthritis
4. Polymalagia Arthritis
5. Cervical myleopathy and spinal canal stenosis
6. Osteoporosis
7. Low back pain
8. Fibromyalgia


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.

                                        The Causes 

1. Oxidative stress
There are some evidences demonstrating that oxidative stress is associated to clinical symptoms in chronic pain syndrome of fibromyalgia(8), particular in lipid peroxidation (LPO) in blood mononuclear cells (BMCs) and plasma(9).
According to the Universidad de Sevilla, mitochondrial dysfunction is found to associated to the increased risk of fibromyalgia, probably due to CoQ10 deficiency in blood mononuclear cells(10).
In a total of 60 female study conduced by the King George's Medical University study, oxidative stress is a major cause of FMS. Moreover, the increased oxidative stress parameters are more strongly associated with severity of FMS.(11).

2. Chronic stress and psychological symptoms
The relationship between stress, depression and functionality seems to be part of a complex mechanism, which might affect the quality of life of patients with FM(12). According to the study led by the Universidade Federal de São Paulo, Stress index (96%), trait anxiety (over 50) and clinically relevant depression (greater than 20) are found in the female patient with FMS(13).
In spouses of sexually active reproductive women with fibromyalgia, Dr. Yener M and colleagues at the said, "FM can cause deterioration of emotional status and lead to sexual dysfunction" and "Also, psychological status could be affected in spouses of women with FM at reproductive age, and the severity of depression of their spouses was significantly correlated to that of women with FM"(14).

3. Alpha1-Antitrypsin (AAT)
There is  a possible relationship between AAT deficiency (AAT-D) and fibromyalgia (FM) due to
inflammation(15). According to the Hospital Valle del Nalón, AAT replacement therapy has shown to induce a rapid, progressive, and constant control of their FM symptoms, in 2 Spanish sisters with alpha1-antitrypsin (AAT) deficiency and fibromyalgia (FM)(16).

4. Inflammatory rheumatic disorders
There is evidence to suggest that fibromyalgia occurs much more frequently than expected in
individuals with inflammatory rheumatic disorders(17). According to the cross-sectional study carried out in a hospital-based rheumatology unit. Standard clinical and laboratory data, FM patients with inflammatory and patients with non inflammatory rheumatic disorders, experience to fibromyalgic features dominate and become the main cause of morbidity(18).
Dr. Jiao J and colleagues at the joint study led by the China Academy of Chinese Medical Sciences, said, "FM patients with rheumatic diseases were found to have worse SF-36-assessed pain and physical health and less improvement in these measures following treatment from FTP than patients withoutrheumatic diseases. FM patients with rheumatic disease may require additional intervention to address underlying rheumatic disease-related limitations."(19).

5. Sleep disturbance
There is a reciprocal relationship exists between pain and sleep, and that intervention targeted primarily at insomnia may improve pain(20). According to the jopint study led by the Penn State College of Medicine, rates of CFS, FM or CFS + FM were high: 13% in SDB and 48% in insomnia. CFS occurred frequently in SDB and insomnia, but FM occurred frequently only in insomnia(21).
There is a report that low sleep quality has induced sexual dysfunction in female patients with fibromyalgia(22).
6. Etc.

(8) Oxidative stress correlates with headache symptoms in fibromyalgia: coenzyme Q₁₀ effect on clinical improvement by Cordero MD1, Cano-García FJ, Alcocer-Gómez E, De Miguel M, Sánchez-Alcázar JA(PubMed)
(9) Clinical symptoms in fibromyalgia are better associated to lipid peroxidation levels in blood mononuclear cells rather than in plasma by Cordero MD1, Alcocer-Gómez E, Cano-García FJ, De Miguel M, Carrión AM, Navas P, Sánchez Alcázar JA.(PubMed)
(10) Oxidative stress and mitochondrial dysfunction in fibromyalgia by Cordero MD1, de Miguel M, Carmona-López I, Bonal P, Campa F, Moreno-Fernández AM.(PubMed)
(11) Some oxidative and antioxidative parameters and their relationship with clinical symptoms in women withfibromyalgia syndrome by Fatima G1, Das SK2, Mahdi AA1.(PubMed)
(12) Stress perception and depressive symptoms: functionality and impact on the quality of life of women withfibromyalgia, [Article in English, Portuguese] by Homann D1, Stefanello JM, Góes SM, Breda CA, Paiva Edos S, Leite N.(PubMed)
(13) Investigation of stress, anxiety and depression in women with fibromyalgia: a comparative study.
[Article in English, Portuguese] by Ramiro Fde S1, Lombardi Júnior I2, da Silva RC3, Montesano FT1, de Oliveira NR2, Diniz RE4, Alambert PA4, Padovani Rda C5.(PubMed)
(14) The evaluation of anxiety and depression status in spouses of sexually active reproductive women with fibromyalgia by Yener M1, Askin A1, Soyupek F1, Akpinar A2, Demirdas A2, Sonmez S3, Soyupek S3.(PubMed)
(15) alpha1-Antitrypsin and fibromyalgia: new data in favour of the inflammatory hypothesis of fibromyalgia by Blanco LE1, de Serres FJ, Fernańdez-Bustillo E, Kassam DA, Arbesú D, Rodríguez C, Torre JC.(PubMed)
(16) Alpha1-antitrypsin replacement therapy controls fibromyalgia symptoms in 2 patients with PI ZZ alpha1-antitrypsin deficiency by Blanco I1, Canto H, de Serres FJ, Fernandez-Bustillo E, Rodríguez MC.(PubMed)
(17) The Overlap Between Fibromyalgia and Inflammatory Rheumatic Disease: When and Why Does it Occur? by Clauw DJ1, Katz P.(PubMed)
(18) The impact of concomitant fibromyalgia on visual analogue scales of pain, fatigue and function in patients with various rheumatic disorders by Levy O1, Segal R2, Maslakov I3, Markov A3, Tishler M3, Amit-Vazina M3.(PubMed)
(19) Association of rheumatic diseases with symptom severity, quality of life, and treatment outcome in patients withfibromyalgia by Jiao J1,2, Davis Iii JM3, Cha SS4, Luedtke CA5, Vincent A6, Oh TH2,5.(PubMed)
(20) Does effective management of sleep disorders improve pain symptoms? by Roehrs TA1; Workshop Participants.(PubMed)
(21) Chronic fatigue syndrome and fibromyalgia in diagnosed sleep disorders: a further test of the 'unitary' hypothesis. by Pejovic S1, Natelson BH2, Basta M3, Fernandez-Mendoza J4, Mahr F5, Vgontzas AN6.(PubMed)
(22) Effects of low sleep quality on sexual function, in women with fibromyalgia by Amasyali AS1, Taştaban E2, Amasyali SY3, Turan Y2, Kazan E1, Sari E4, Erol B5, Cengiz M6, Erol H1.(PubMed)

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