Most common Diseases of Ages of 50+: Fibromyalgia - The Diagnosis and Preventions

Home of Kyle J. Norton for The Better of Living & Living Health 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.
IV. Diagnosis
In the narrative review of the literature, consensus documents by the American College of Rheumatology (ACR), evidence-based interdisciplinary German guidelines on the diagnosis and management of FMS by Klinikum Saarbrücken Internal Medicine 1 Winterberg 1 D-66119 Saarbrücken, the recommendations of a stepwise diagnostic work-up of patients with chronic widespread pain (CWP) in primary care include: Complete medical history including medication, complete medical examination, basic laboratory tests to screen for inflammatory or endocrinology diseases, referral to specialists only in case of suspected somatic diseases, assessment of limitations of daily functioning, screening for other functional somatic symptoms and mental disorders, and referring to mental health specialists in case of mental disorder(20). Other study suggested of 4 phased diagnosis. In phase one, physicians undertook a self-assessment of their practice. Phase two of the study involved diagnosis and treatment of a virtual case vignette. The third phase consisted of analysis of the data from phase two and providing feedback from an expert rheumatologist, and the fourth phase was to complete patient report forms for five patients in their practice(21).
Here we quote the text from the study of The American College of Rheumatology Preliminary Diagnostic Criteria for Fibromyalgiaand Measurement of Symptom Severity by FREDERICK WOLFE,1 DANIEL J. CLAUW,2 MARY-ANN FITZCHARLES,3 DON L. GOLDENBERG,4
ROBERT S. KATZ,5 PHILIP MEASE,6 ANTHONY S. RUSSELL,7 I. JON RUSSELL,8 JOHN B. WINFIELD,9 AND MUHAMMAD B. YUNUS10
Objective. To develop simple, practical criteria for clinical diagnosis of fibromyalgia that are suitable for use in primary and specialty care and that do not require a tender point examination, and to provide a severity scale for characteristic fibromyalgia symptoms.
Methods. We performed a multicenter study of 829 previously diagnosed fibromyalgia patients and controls using physician physical and interview examinations, including a widespread pain index (WPI), a measure of the number of painful body regions. Random forest and recursive partitioning analyses were used to guide the development of a case definition of fibromyalgia, to develop criteria, and to construct a symptom severity (SS) scale.
Results. Approximately 25% of fibromyalgia patients did not satisfy the American College of Rheumatology (ACR) 1990 classification criteria at the time of the study. The most important diagnostic variables were WPI and categorical scales for cognitive symptoms, unrefreshed sleep, fatigue, and number of somatic symptoms. The categorical scales were summed to create an SS scale. We combined the SS scale and the WPI to recommend a new case definition of fibromyalgia: (WPI >7 AND SS >5) OR (WPI 3–6 AND SS >9).
Conclusion. This simple clinical case definition of fibromyalgia correctly classifies 88.1% of cases classified by the ACR classification criteria, and does not require a physical or tender point examination. The SS scale enables assessment of fibromyalgia symptom severity in persons with current or previous fibromyalgia, and in those to whom the criteria have not been applied. It will be especially useful in the longitudinal evaluation of patients with marked symptom variability.
Please note:
This criteria set has been approved by the American College of Rheumatology (ACR) Board of Directors as Provisional.This signifies that the criteria set has been quantitatively validated using patient data, but it has not undergone validationbased on an external data set. All ACR-approved criteria sets are expected to undergo intermittent updates.As disclosed in the manuscript, these criteria were developed with support from the study sponsor, Lilly Research Laboratories.The study sponsor placed no restrictions, offered no input or guidance on the conduct of the study, did not participatein the design of the study, see the results of the study, or review the manuscript or submitted abstracts prior to thesubmission of the paper. The recipient of the grant was Arthritis Research Center Foundation, Inc. The authors receivedno compensation. The ACR found the criteria to be methodologically rigorous and clinically meaningful.ACR is an independent professional, medical and scientific society which does not guarantee, warrant or endorse anycommercial product or service. The ACR received no compensation for its approval of these criteria(22).

V. Preventions
1. Vitamin D
Vitamin D deficiency is associated with anxiety and depression in fibromyalgia. In a study of Seventy-five Caucasian patients who fulfilled the ACR criteria for fibromyalgia had serum vitamin D levels measured and completed the Fibromyalgia Impact Questionnaire (FIQ) and Hospital Anxiety and Depression showed that Vitamin D deficiency is common in fibromyalgia and occurs more frequently in patients with anxiety and depression. The nature and direction of the causal relationship remains unclear, but there are definite implications for long-term bone health(23).

2. Omega 3 fatty acid
In the study to investigate and report on patients with neuropathic pain who responded to treatment with omega-3 fatty acids, five patients with different underlying diagnoses including cervical radiculopathy, thoracic outlet syndrome, fibromyalgia, carpal tunnel syndrome, burn injury were treated with high oral doses of omega 3 fish oil (varying from 2400-7200 mg/day of EPA-DHA), found thatthese patients had clinically significant pain reduction, improved function as documented with both subjective and objective outcome measures up to as much as 19 months after treatment initiation. No serious adverse effects were reported(24).

3. Caffeine
In a study of forty-three of fifty-eight (74.1%) female patients with fibromyalgia completed an eight-week treatment period testing the combination of carisoprodol, paracetamol (acetaminophen) and caffeine versus placebo, found that the combination of carisoprodol and paracetamol (acetaminophen) and caffeine are effective in the treatment of fibromyalgia(25).

4. Coenzyme Q10 
CoQ10 treatment restored mitochondrial dysfunction and the mtDNA copy number, decreased oxidative stress, and increased mitochondrial biogenesis. Our results suggest that CoQ10 could be an alternative therapeutic approach for FM(26).

 Natural Remedy For Arthritis, Gout, And Rheumatism
Discover An Amazing, All-natural System That 
Literally Stops Arthritis, Gout, And Rheumatism In As Little As 7 Days. 

For common types of diseases of Ages of 50+, please visit http://medicaladvisorjournals.blogspot.ca/p/better-of-living-health-50-over.html

For other health article, visit http://medicaladvisorjournals.blogspot.ca       

Sources
(a) http://www.ncbi.nlm.nih.gov/pubmed/2306288
(21) http://www.ncbi.nlm.nih.gov/pubmed/23118542
(22) http://www.rheumatology.org/practice/clinical/classification/fibromyalgia/2010_Preliminary_Diagnostic_Criteria.pdf
(23) http://www.ncbi.nlm.nih.gov/pubmed/16850115
(24) http://www.ncbi.nlm.nih.gov/pubmed/20090445
(25) http://www.ncbi.nlm.nih.gov/pubmed/2667860
(26) http://www.ncbi.nlm.nih.gov/pubmed/22898267

http://medicaladvisorjournals.blogspot.com