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Fibromyalgia Community Newsletter # 3/1 Friday, 12/14/2001
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This week's News Summary
1) Research: Hemodynamic instability in chronic fatigue syndrome
2) Article : FM news and information
3) Research: Levels and Stability of the Alpha Sleep Anomaly
4) Research: Conscious and automatic uses of memory in chronic pain patients.
5) Article : Advice to a New Patient
6) Article : FDA Says Antidepressant Must Carry Warning: Paper
7) Article : Sexual Desire and FMS
8) Research: Pain, Pleasure Take Similar Path in Brain: Study
9) Article : 358 New Medicines for Women
10) Article : Holiday Survival Guide
11) Research: Focus On Osteoporosis
12) Research: Beneficial Effects Of Exercise On Osteoarthritis Wane Over Time
13) Research: Gene May Link Inflammatory Disease Of Spine/Joints, Skin, Eye And Bowel
14) Research: Getting the FDA Hooked on Ecstasy
15) Research: New Depression And Anxiety Treatment Goals Defined
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Full Stories Are Available Via Web Links
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1)
Subject: Hemodynamic instability in chronic fatigue syndrome Source : Journal: Semin Arthritis Rheum 2001 Dec;31(3):199-208 Author : Authors: Naschitz JE, Sabo E, Naschitz S, Shaviv N, Rosner I, Rozenbaum M, Gaitini L, Ahdoot A, Ahdoot M, Priselac RM, Eldar S, Zukerman E, Yeshurun D.
URL :
Hemodynamic instability in chronic fatigue syndrome: Indices and diagnostic significance.
Affiliations: Department of Internal Medicine A, Department of Rheumatology, Department of Anesthesiology, and Department of Surgery, Bnai Zion Medical Center and Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.
NLM Citation: PMID: 11740800
OBJECTIVES: To evaluate the cardiovascular response to postural challenge in patients with chronic fatigue syndrome (CFS) and to determine whether the degree of instability of the cardiovascular response may aid in diagnosing CFS.
METHODS: Patients with CFS (n = 25) and their age- and gender-matched healthy controls (n = 37), patients with fibromyalgia (n = 30), generalized anxiety disorder (n = 15), and essential hypertension (n 20) were evaluated with the aid of a standardized tilt test. The blood pressure (BP) and heart rate (HR) were recorded during 10 minutes of recumbence and 30 minutes of head-up tilt. We designated BP changes as the differences between successive BP values and the last recumbent BP.
The average and standard deviation (SD) were calculated. Time curves of BP differences were loaded into a computerized image analyzer, and their outline ratios and fractal dimensions were measured. HR changes were determined similarly. The average and SD of the parameters were calculated, and intergroup comparisons were performed.
RESULTS: On multivariate analysis, the independent predictors of CFS patients versus healthy controls were the fractal dimension of absolute values of the systolic BP changes (SYST-FD.abs), the standard deviation of the current values of the systolic BP changes (SYST-SD.cur), and the standard deviation of the current values of the heart rate changes (HR-SD.cur). The following equation was deduced to calculate the hemodynamic instability score (HIS) in the individual patient: HIS
64.3303 + (SYST-FD.abs x -68.0135) + (SYST-SD.cur x 111.3726) + (HR-SD.cur x 60.4164). The best cutoff differentiating CFS from the healthy controls was -0.98. HIS values >-0.98 were associated with CFS (sensitivity 97%, specificity 97%). The HIS differed significantly between CFS and other groups (P <.0001) except for generalized anxiety disorder. Group averages (SD) of HIS were CFS = +3.72 (5.02), healthy
-4.62 (2.26), fibromyalgia = -3.27 (2.63), hypertension = -5.53 (2.24), and generalized anxiety disorder = +1.08 (5.2).
CONCLUSION: The HIS adds objective criteria confirming the diagnosis of CFS.
Semin Arthritis Rheum 31:199-208. Copyright 2001 by W.B. Saunders Company
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2)
Subject: FM news and information from the 2001 American College of Rheumatology Annual Scientific Meeting Source : fmaware.org Author : Lisa Lorden URL: http://fmaware.org/patient/research/acr2001.htm
A compilation of FM news and information from the 2001 American College of Rheumatology Annual Scientific Meeting in San Francisco, written by Lisa Lorden, is available at
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3)
Subject: Levels and Stability of the Alpha Sleep Anomaly in Insomniac Subjects Source : Tri-State Sleep Disorders Center, Cincinnati, Ohio Author : Robin Stover, Carol Conrad, Kimberly Kelly, George Spinner, Martin B Scharf URL : http://www.websciences.org/apss/1999/pdf/C334.pdf
Introduction: The intrusion of alpha rhythm into non REM sleep (the alpha sleep anomaly) was first described by Hauri & Hawkins in 1973 in nine psychiatric patients with somatic malaise and fatigue. It was subsequently reported by Mol-dolfsky and confirmed by a number of other investigators. It has also been reported to occur in normals, in patients with chronic fatigue syndrome, rheumatoid arthritis, depression, and has frequently been observed in routine rule out nights in patients with a history of obstructive sleep apnea. We recently reported that gammahydroxybutyrate* administration resulted in marked reduction in the alpha anomaly in patients with fibromyalgia. This was accompanied by reductions in pain and fatigue and an increase in slow wave sleep. While a significant amount of data suggests the importance of the alpha anomaly in this disorder, the phenomenon itself has not been well characterized in terms of consistency from night to night in different subjects or patient populations.
Methods: We quantified the levels of the alpha anomaly present in the polysomnographic evaluations conducted in 10 insomniac patients who slept in our laboratory for 4 consecutive nights as part of a baseline evaluation for a hypnotic drug trial. Each subject had a polysomnographically con-firmed history of difficulty falling asleep and staying asleep that they subjectively claimed impacted on daytime performance and alertness. Subjects slept in the laboratory for 8 hours each night with Night 1 being used as a rule out for the presence of significant obstructive sleep apnea and/or periodic limb movements and the subsequent 3 nights without the encumbrance of the additional respiratory equipment or tibialis EMG electrodes. Records were scored independently and blindly by 3 scorers on an epoch by epoch basis for the presence or absence of visually observed alpha activity in NREM sleep.
Conclusions: Results of the study indicate the clear presence of the alpha anomaly in patients with complaints of sleep difficulty. The levels seen in these insomniac patients were below those reported in our patients with fibromyalgia. The stability within subjects from night to night was marked and there did not appear to be a first night effect similar to that seen with other sleep parameters. Further, interscorer consistency was high. Further studies are ongoing to characterize the nightly levels of alpha intrusion in normals, fibromyalgia patients, and other patient populations.
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*gammahydroxybutyrate (GHB, Xyrem) is not yet available by prescription in the USA. Successful studies are nearing completion and it is expected that this drug will be available in the USA in the future. I do not know its status outside of the USA. Side effects are said to be: lack of coordination, nausea, respiratory distress, and occasionally seizures.
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4)
Subject: Conscious and automatic uses of memory in chronic pain patients.
Source : Pain 2001 Dec;94(3):305-13 Author : Grisart JM, Van der Linden M.
URL :
Service de Medecine Physique et Readaptation, Cliniques universitaires Saint-Luc, Universite catholique de Louvain, Avenue Hippocrate 10, B-1200, Brussels, Belgium
Memory deficits in chronic pain patients are frequently observed. The objective of this study was to explore memory performances of chronic pain patients by using the Process Dissociation Procedure developed by Jacoby (J. Mem. Lang. 30 (1991) 513).
This procedure permits to separate the contribution of controlled processes from automatic processes operating within a memory task.
The results show a significant decrease of controlled processes in chronic pain patients. Furthermore for both groups, automatic processes contribute in a similar extent to the memory performance. The estimates of controlled processes in the chronic pain patients are significantly related to the fear of pain and catastrophizing beliefs.
This is interpreted as a sign of interference between the attention consumed by pain experience (namely fear related to pain) and the attention to be allocated to the memory task.
PMID: 11731067
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5)
Subject: Advice to a New Patient Source : CFIDS/Fibromyalgia Self-Help <http://CFIDSselfhelp.org>http://CFIDSselfhelp.org Author : Bruce Campbell URL :
<http://home.flash.net/~brucepa/index.htm>http://home.flash.net/~brucepa/index.htm
What are the most important things to remember in coping with chronic illness? Read some answers from fellow patients in this week's feature article "Advice to a New Patient" at the CFIDS/Fibromyalgia Self-Help Program.
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6)
Subject: FDA Says Antidepressant Must Carry Warning: Paper Source : yahoo.com Author :
URL :
http://dailynews.yahoo.com/h/nm/20011207/hl/antidepressant_1.html
<quote>
NEW YORK (Reuters) - The US Food and Drug Administration (news - web sites) (FDA) has told drugmaker Bristol-Myers Squibb Co. that it must include a so-called black-box warning on its label for the antidepressant Serzone informing patients that rare but perhaps life-threatening liver damage can occur when using the drug, The Wall Street Journal reported on Friday.
The agency sent New York-based Bristol-Myers the notice this week and will soon require the company to warn doctors that a small number of patients could suffer from liver failure, leading to death or the need for a liver transplant, the newspaper said in its online edition.
(....)
Read the full article on the website.
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7)
Subject: Sexual Desire and FMS Source : myalgia.com Author : Connie O'Reilly Ph.D.
URL : http://www.myalgia.com/connie1.htm
<quote>
What if I just don't feel like it?
- Our society puts tremendous pressure on us to be sexual.
Television and movies convince us that unless we have wild passionate rip-your-clothes-off sex in odd or unusual places at least weekly (preferably several times daily), we must have some sexual hang-up.
Living with the Madison Avenue image of what is beautiful leaves most of us with some significant insecurity about our bodies. We doubt that anyone could find us desirable because we are not among the "beautiful people." The body changes, pain, and fatigue associated with illness can zap sexual desire further. Anxiety, depression or the medications used to control those conditions can decrease one's libido. Also, antihypertensives, ulcer medications, and others may have similar effects.
So what can I do about it?
(....)
Read the full article on the website.
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Subject: Pain, Pleasure Take Similar Path in Brain: Study Source : Reuters Author : Dr. David Borsook URL : http://www.nlm.nih.gov/medlineplus/news/fullstory_5088.html
NEW YORK, Dec 05 (Reuters Health) - Scientists have discovered that the brain's response to pain appears to follow a path similar to that of the pleasure response.
The findings could one day lead to better treatments for people suffering chronic pain, according to lead author Dr. David Borsook of Massachusetts General Hospital in Boston.
(....)
Read the full article on the website.
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9)
Subject: 358 New Medicines for Women Source : SafetyAlerts.com Author :
URL : http://www.safetyalerts.com/t/g/womendesease.htm
<quote> Diseases That Primarily Affect Women are Targets of 358 New Medicines In the Pharmaceutical Pipeline
(SafetyAlerts) - Pharmaceutical companies are developing 358 new medicines to target more than 30 diseases that disproportionately affect women, a new survey released today by the Pharmaceutical Research and Manufacturers of America (PhRMA) found.
(....)
Read the full article on the website.
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10)
Subject: Holiday Survival Guide Source : fmaware.org Author : Lisa Lorden URL : http://FMaware.org/patient/coping/holidays.htm
<quote>
Part 1: How to Fight Fatigue and Avoid the Holiday Blues http://fmaware.org/patient/coping/holidays.htm
Part 2: What You Can Do Before the Holidays Begin http://fmaware.org/patient/coping/holidays2.htm
Part 3: What You Can Do During the Holidays http://fmaware.org/patient/coping/holidays2.htm
Part 4: Part 4: Coping Strategies for After the Holidays http://fmaware.org/patient/coping/holidays4.htm
by Lisa Lorden
Whether you celebrate Christmas, Hanukkah, Kwanza, or another holiday at this time of year, "Tis the season to be jolly..." may ultimately be a paradox for those with Fibromyalgia or any chronic illness. What should be a time filled with joy and celebration is often one of loss and sadness for those who live with debilitating illness. Eugene Kennedy, author of The Pain of Being Human, wrote "Some of man's darkest hours black out the skies he feels should be the brightest."
(....)
Read the full articles on the website.
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11)
Subject: Focus On Osteoporosis Source : medscape.com Author :
URL : http://www.medscape.com/mp/rc/osteoporosis
What are the effects of hormonal contraception on bone mineral density?
A prospective, controlled study was performed, and Medscape Journal Scan reports the results in an original summary. It's one of the many clinical articles available now in Medscape's Osteoporosis Resource Center.
Read the full articles on the website.
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12)
Subject: Beneficial Effects Of Exercise On Osteoarthritis Wane Over Time Source : medscape.com Author :
URL : http://rheumatology.medscape.com/45754.rhtml?srcmp=rheu-120701
Beneficial Effects Of Exercise On Osteoarthritis Wane Over Time Exercise benefits patients with osteoarthritis (OA) of the knee or hip, but the effects decline over time and eventually disappear, according to a report in the December issue of the Annals of Rheumatic Diseases.
Read the full articles on the website.
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13)
Subject: Gene May Link Inflammatory Disease Of Spine/Joints, Skin, Eye And Bowel Source : docguide.com/Journal of Rheumatology Author : By Anne MacLennan URL :
http://www.docguide.com/news/content.nsf/NewsPrint/8525697700573E1885256B1B00716364
<quote>
DGReview
Gene May Link Inflammatory Disease Of Spine/Joints, Skin, Eye And Bowel A DGReview of :"Inflammatory Eye, Skin, and Bowel Disease in Spondyloarthritis: Genetic, Phenotypic, and Environmental Factors"
A shared gene may account for a striking overlap of rheumatological, dermatological, and gastroenterological diseases within patients and family members.
This is the suggestion of a study of genetic, phenotypic and environmental factors in inflammatory eye, skin and bowel disease in spondyloarthritis.
Study objective was to explore the nature of the interrelationship between inflammatory disease of the spine/joints, skin, eye, and bowel (ie, ankylosing spondylitis [AS], psoriasis, iritis, inflammatory bowel disease [IBD]).
The researchers used four different approaches: 1) analysis of the prevalence of secondary disorders within the AS individual (chi-square and matched pair analysis); 2) study of the temporal relationship between the onset of the different conditions; 3) evaluation of the prevalence of disease among first-degree relatives; and 4) influence of secondary disorders on outcome of AS.
(....)
Read the full article on the website.
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14)
Subject: Getting the FDA Hooked on Ecstasy Source : wired.com Author : Kristen Philipkoski URL :
http://www.wired.com/news/medtech/0,1286,48547,00.html?tw=wn20011210
<quote>
An advocate of psychedelic drugs is doing something that Ken Kesey and Timothy Leary thought unthinkable: cooperating with government bureaucrats.
Rick Doblin and his colleagues at the Multidisciplinary Association for Psychedelic Studies (MAPS) have put together the first FDA-approved human study in 16 years using Ecstasy (MDMA) as a therapy aide.
It's the first step on a path that Doblin hopes will lead to making certain hallucinogens legal for the treatment of psychological disorders.
(....)
Read the full article on the website.
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15)
Subject: New Depression And Anxiety Treatment Goals Defined Source : docguide.com/National Mental Health Association Author : National Mental Health Association URL :
http://www.docguide.com/news/content.nsf/NewsPrint/8525697700573E1885256B18004A308A
<quote>
NEW YORK, NY -- December 4, 2001 -- To be successful, treatment for the more than 20 million Americans suffering from depression and anxiety must aim not for partial improvement of the illness but for remission (virtual elimination of symptoms) and complete recovery of quality of life, according to an expert panel comprised of leading U.S. mental health clinicians, researchers, consumers and advocates convened by the National Mental Health Association (NMHA) on Friday, Nov. 30th, in New York City.
"The panel's ability to find a common ground between the medical and consumer models of treatment for people with depression and anxiety is a major achievement," said Michael M. Faenza, M.S.S.W., NMHA president and CEO and moderator of the roundtable, "The Science of Remission, The Art of Recovery."
(....)
Read the full article on the website.
