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Biomedical subjects

A T Masi

Publications and source records attributed to A T Masi.

At least 19 recordsLinked to original sources
PubMed1992

Plasma tryptophan and other amino acids in primary fibromyalgia: a controlled study.

To test the hypothesis that plasma tryptophan and/or its transport ratio is decreased in primary fibromyalgia (PF), we measured plasma tryptophan and its transport ratio in 29 patients with PF and 30 healthy controls without significant pain, in a blinded manner. Twenty-one other amino acids were also similarly analyzed among these study subjects. Transport ratio of tryptophan was found to be significantly (p less than 0.01) decreased in PF compared with the control group (0.09 +/- 0.02 vs 0.10 +/- 0.02). Plasma tryptophan level was lower in PF (45 +/- 10 nmol/ml) than in healthy controls (51 +/- 15 nmol/ml), showing a trend towards significance (p less than 0.09). Additionally, plasma histidine and serine levels were found to be significantly (p less than 0.01) lower in patients with PF than in controls. Our results suggest that a decreased brain serotonin level, as possibly reflected by a decreased transport ratio of plasma tryptophan, may play a pathophysiologic role in PF.

Amino Acids↗
PubMed1992

Plasma and urinary catecholamines in primary fibromyalgia: a controlled study.

Plasma and urinary catecholamines were measured in a blinded manner among 30 patients with primary fibromyalgia (PF) and 30 healthy controls without significant pain to determine possible elevations of catecholamines in PF, as well as their correlations with psychological and clinical variables in this syndrome. Results showed no significant differences between fibromyalgia and control groups in any of the catecholamines measured, nor was there a correlation between catecholamine levels and any of the clinical features or psychologic measures.

Adult↗
PubMed1992

Do sex hormones play a role in ankylosing spondylitis?

Ankylosing spondylitis (AS) has a striking disease marker, i.e., HLA-B27, indicating the major genetic predisposition; however, expression of disease is also strongly influenced by age- and sex-related factors. Sex steroids studies suggest greater androgenicity in AS than normal control persons. Therapeutic interventions that normalize such sex steroid status have shown clinical improvements in males and females. Muscle histopathology in AS shows frequent changes early in disease consistent with neuropathic and myopathic mechanisms of a noninflammatory nature. Accepting the available, aggregate data, one may infer that sex steroid imbalance in persons susceptible to AS may target axial and proximal muscle tissues, resulting in relative functional hypertonicity. Such phenomenon, developing in preteen and younger adult ages, may contribute to peripheral and axial manifestations of enthesopathy in this disease by complex and currently unknown mechanisms.

Aging↗
PubMed1991

Relationship of clinical features with psychological status in primary fibromyalgia.

Clinical features and psychological status determined by the Minnesota Multiphasic Personality Inventory (MMPI) in 103 patients with primary fibromyalgia syndrome (PFS) were analyzed by univariate and multivariate techniques to determine if clinical features were related to psychological status or were intrinsic to PFS per se. The central features of PFS, e.g., number of pain sites, number of tender points, fatigue, and poor sleep, were independent of psychological status. However, discriminant analysis identified 4 variables--patient-reported depression, anxiety, stress, and pain severity--which together predicted 3 MMPI subgroups with an accuracy of 55% (P less than 0.001); the only musculoskeletal feature--pain severity--alone provided an accuracy of only 34% (P greater than 0.05). These data suggest a new concept, that the central features of fibromyalgia are independent of the psychological status and are more likely related to the PFS itself. However, pain severity may be influenced by psychological factors.

Adult↗
PubMed1991

Psychiatric status of patients with primary fibromyalgia, patients with rheumatoid arthritis, and subjects without pain: a blind comparison of DSM-III diagnoses.

OBJECTIVE: The major purpose of this study was to compare the frequency of the occurrence of DSM-III diagnoses in patients with primary fibromyalgia syndrome, patients with rheumatoid arthritis, and subjects without pain. METHOD: Thirty-five patients with primary fibromyalgia, 33 patients with rheumatoid arthritis, and 31 nonpatients without pain were blindly assessed for psychiatric diagnoses with the Psychiatric Diagnostic Interview. RESULTS: Data from this interview revealed no group differences in terms of lifetime history of any psychiatric disorders, including major depression, somatization disorder, or anxiety-based disorders. Analysis of the auxiliary symptoms of depression on the Psychiatric Diagnostic Interview revealed that the patients with fibromyalgia did not report a higher frequency of vegetative signs of depression. However, analysis of the somatization scale revealed an interaction between medical and psychiatric diagnoses: patients with primary fibromyalgia syndrome and a psychiatric history endorsed significantly more somatic symptoms than did patients with rheumatoid arthritis or subjects without pain, and fibromyalgia patients without a psychiatric history were no more likely to endorse somatic symptoms than were arthritis patients or subjects without pain. CONCLUSIONS: The Psychiatric Diagnostic Interview data failed to discriminate in any major way between primary fibromyalgia syndrome (a disorder with no known organic etiology) and rheumatoid arthritis (a disorder with a known organic etiology). Therefore, these data do not support a psychopathology model as a primary explanation of the symptoms of primary fibromyalgia syndrome.

Adult↗
PubMed1990

The American College of Rheumatology 1990 criteria for the classification of Churg-Strauss syndrome (allergic granulomatosis and angiitis).

Criteria for the classification of Churg-Strauss syndrome (CSS) were developed by comparing 20 patients who had this diagnosis with 787 control patients with other forms of vasculitis. For the traditional format classification, 6 criteria were selected: asthma, eosinophilia greater than 10% on differential white blood cell count, mononeuropathy (including multiplex) or polyneuropathy, non-fixed pulmonary infiltrates on roentgenography, paranasal sinus abnormality, and biopsy containing a blood vessel with extravascular eosinophils. The presence of 4 or more of these 6 criteria yielded a sensitivity of 85% and a specificity of 99.7%. A classification tree was also constructed with 3 selected criteria: asthma, eosinophilia greater than 10% on differential white blood cell count, and history of documented allergy other than asthma or drug sensitivity. If a subject has eosinophilia and a documented history of either asthma or allergy, then that subject is classified as having CSS. For the tree classification, the sensitivity was 95% and the specificity was 99.2%. Advantages of the traditional format compared with the classification tree format, when applied to patients with systemic vasculitis, and their comparison with earlier work on CSS are discussed.

Adolescent↗
PubMed1989

Multiphase skeletal scintigraphy in primary fibromyalgia syndrome: a blinded study.

Sixteen patients with primary fibromyalgia syndrome were assessed blindly by multiphase skeletal scintigraphy to detect possible subclinical synovitis and uptake abnormalities at tender point sites. Results were normal in 14 of the 16 patients. Mild and localized abnormalities were found in 2 patients and were possibly due to the trauma of overuse. Our multiphase skeletal scintigraphy study showed that synovitis, other evidence of arthritis, or abnormalities at tender point sites were not increased above normal expectation among our sample of patients studied with fibromyalgia.

Adolescent↗
PubMed1989

Short term effects of ibuprofen in primary fibromyalgia syndrome: a double blind, placebo controlled trial.

Therapeutic effects of ibuprofen were evaluated in 46 patients with primary fibromyalgia syndrome in a double blind, placebo controlled study for 3 weeks and in an open trial for another 3 weeks. Several features of primary fibromyalgia syndrome, including number of pain sites, fatigue, swelling feeling, and tender points significantly improved over time in both groups. However, no significant differences were found between the ibuprofen and placebo groups. Improvements in fibromyalgia features might have occurred as a result of physician or study interactions (i.e., an intervention effect). An important observation in our blinded study was that tender point sites among patients with fibromyalgia were significantly (p less than 0.001) consistent at 3 as well as 6 weeks when compared with the baseline.

Adult↗
PubMed1989

A controlled study of primary fibromyalgia syndrome: clinical features and association with other functional syndromes.

One hundred and thirteen patients with primary fibromyalgia syndrome, 77 with rheumatoid arthritis (RA) and 67 healthy controls without significant aches or pains were studied by protocol to determine clinical features of primary fibromyalgia syndrome and to assess the possible association of primary fibromyalgia syndrome with common functional disorders compared with the control groups. Previously reported common features of primary fibromyalgia syndrome are confirmed in this controlled study. In addition the extent of cutaneous hyperemia on palpation was found to be greater in patients with primary fibromyalgia syndrome than in normal controls. All the 3 functional syndromes evaluated, e.g., irritable bowel, chronic functional headache and primary dysmenorrhea, were significantly (p less than 0.005) more common in primary fibromyalgia syndrome, compared with RA and normal control groups. These data suggest that primary fibromyalgia syndrome is a characteristic clinical condition that overlaps with other well recognized functional syndromes.

Arthritis, Rheumatoid↗
PubMed1989

Electron microscopic studies of muscle biopsy in primary fibromyalgia syndrome: a controlled and blinded study.

Trapezius muscle biopsy was carried out in 21 patients with primary fibromyalgia syndrome (PFS) and 11 healthy controls, and assessed blindly by electron microscopy. Common findings in both the PFS and control groups were mild myofibrillar separation, papillary projections and subsarcolemmal accumulation of glycogen. However, the differences between the 2 groups were not statistically significant in any of the findings.

Adolescent↗
PubMed1988

Prognostic importance of cardiac arrhythmias in systemic sclerosis.

Ambulatory electrocardiography was performed in 183 patients with systemic sclerosis recruited from five centers who were selected to reflect a balanced population with respect to disease extent and duration. Ventricular ectopy occurred in 67 percent of patients and was strongly correlated by both univariate and multivariate analyses with total mortality and with sudden death. By multivariate analysis, ventricular ectopy was strongly associated with increasing patient age and with other evidence of cardiac and pulmonary involvement but not with clinical and laboratory measures of duration and extent of systemic sclerosis. Evidence of myocardial fibrosis thought to be secondary to microvascular alteration is common in systemic sclerosis, but the clinical implications of myocardial involvement are less well appreciated. The present data suggest the need for ambulatory electrocardiography in the clinical assessment of selected patients with systemic sclerosis, especially those with cardiac or pulmonary involvement, as well as for studies of the effects of antiarrhythmic therapy.

Adolescent↗
PubMed1988

Fibromyalgia syndrome among the elderly. Comparison with younger patients.

Thirty-one elderly fibromyalgia (EFM) patients (60 years of age and older) were studied by protocol and compared with 63 younger fibromyalgia (YFM) patients with this syndrome. Common and characteristic features of fibromyalgia among the elderly included diffuse musculoskeletal aching and stiffness at multiple sites; modulation of aches and pains by physical fatigue, poor sleep and weather factors; associated symptoms of general fatigue, poor sleep, anxiety/tension and subjective soft tissue swelling; and multiple tender points on physical examination. These features were similar to those among the younger patients, with the exception of chronic functional headaches, self-assessed anxiety/tension, and symptom aggravation by weather factors, mental stress, and by poor sleep, all of which were significantly less common among the elderly (P less than .05). Importantly, fibromyalgia was recognized by referring physicians in only 17% of the elderly patients with this condition. Misdiagnoses and inappropriate treatment were common among these patients, with corticosteroid therapy in 40% before their rheumatology consultation.

Age Factors↗