Lyme disease: report of two cases. Lyme disease: report of two cases.
East Afr Med J. 2005 May;82(5):267-9
Authors: Jowi JO, Gathua SN
Lyme disease is a tick-borne multisystem disease. It was first described in Lyme, Connecticut, USA in 1975. Cases have been reported in Canada, Switzerland, Austria, Australia and Great Britain. It is an inflammatory disease that has varied clinical manifestations ranging from skin rash (erythema migrans), arthritis, fibromyalgia, and regional lymphadenopathy, cardiac conduction defects to neurological manifestations of meningoencephalitis, Bell's palsy, peripheral neuropathy, and painful radiculoneuropathy. There has been no case record of Lyme disease in Kenya and indeed literature on Lyme disease in Africa is very scanty. We present two cases of Lyme disease with predominant neurological manifestations; outline their clinical presentation and management.
PMID: 16119758 [PubMed - indexed for MEDLINE]
Jowi JO, Gathua SN
Tender point assessment in juvenile primary fibromyalgia syndrome. Tender point assessment in juvenile primary fibromyalgia syndrome.
Arthritis Rheum. 2005 Oct 15;53(5):785-7
Authors: Swain NF, Kashikar-Zuck S, Brent Graham T, Prahalad S
PMID: 16208646 [PubMed - indexed for MEDLINE]
Swain NF, Kashikar-Zuck S, Brent Graham T, Prahalad S
Fibromyalgia syndrome: review of clinical presentation, pathogenesis, outcome measures, and treatment. Fibromyalgia syndrome: review of clinical presentation, pathogenesis, outcome measures, and treatment.
J Rheumatol Suppl. 2005 Aug;75:6-21
Authors: Mease P
Fibromyalgia syndrome (FM) is a common chronic pain condition that affects at least 2% of the adult population in the USA and other regions in the world where FM is studied. Prevalence rates in some regions have not been ascertained and may be influenced by differences in cultural norms regarding the definition and attribution of chronic pain states. Chronic, widespread pain is the defining feature of FM, but patients may also exhibit a range of other symptoms, including sleep disturbance, fatigue, irritable bowel syndrome, headache, and mood disorders. Although the etiology of FM is not completely understood, the syndrome is thought to arise from influencing factors such as stress, medical illness, and a variety of pain conditions in some, but not all patients, in conjunction with a variety of neurotransmitter and neuroendocrine disturbances. These include reduced levels of biogenic amines, increased concentrations of excitatory neurotransmitters, including substance P, and dysregulation of the hypothalamic-pituitary-adrenal axis. A unifying hypothesis is that FM results from sensitization of the central nervous system. Establishing diagnosis and evaluating effects of therapy in patients with FM may be difficult because of the multifaceted nature of the syndrome and overlap with other chronically painful conditions. Diagnostic criteria, originally developed for research purposes, have aided our understanding of this patient population in both research and clinical settings, but need further refinement as our knowledge about chronic widespread pain evolves. Outcome measures, borrowed from clinical research in pain, rheumatology, neurology, and psychiatry, are able to distinguish treatment response in specific symptom domains. Further work is necessary to validate these measures in FM. In addition, work is under way to develop composite response criteria, intended to address the multidimensional nature of this syndrome. A range of medical treatments, including antidepressants, opioids, nonsteroidal antiinflammatory drugs, sedatives, muscle relaxants, and antiepileptics, have been used to treat FM. Nonpharmaceutical treatment modalities, including exercise, physical therapy, massage, acupuncture, and cognitive behavioral therapy, can be helpful. Few of these approaches have been demonstrated to have clear-cut benefits in randomized controlled trials. However, there is now increased interest as more effective treatments are developed and our ability to accurately measure effect of treatment has improved. The multifaceted nature of FM suggests that multimodal individualized treatment programs may be necessary to achieve optimal outcomes in patients with this syndrome.
PMID: 16078356 [PubMed - indexed for MEDLINE]
Mease P
[Is fibromyalgia a disease? Regarding the contribution in DMW 23/2004] [Is fibromyalgia a disease? Regarding the contribution in DMW 23/2004]
Dtsch Med Wochenschr. 2005 May 20;130(20):1278; author reply 1278-9
Authors: Hakimi R
PMID: 15889331 [PubMed - indexed for MEDLINE]
Hakimi R
Technorati Tags:
fibromyalgia causes
