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Biomedical subjects

M B Yunus

Publications and source records attributed to M B Yunus.

At least 37 records · Page 2Linked to original sources
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

Muscle biopsy findings in primary fibromyalgia and other forms of nonarticular rheumatism.

Virtually all the reports on muscle biopsy in chronic muscle pain conditions, except those of primary fibromyalgia syndrome (PFS) published recently, have inadequate methodologic information, particularly on definition of cases, and lack controlled materials, so that no firm conclusions may be made. A limited number of controlled studies of muscle biopsy in PFS suggest that results are negative by usual light microscopic, histochemical, and electron microscope examinations. The findings of abnormal rubber band-like structures and interconnecting network of reticular or elastic fibers in muscle fibers of certain PFS patients in a single study need to be confirmed by other centers by careful controlled and blinded observations. The findings that high-energy phosphate levels in tender PFS muscles are significantly reduced appear valid and important, and need to be independently confirmed by well-designed controlled and blinded studies. Finally, biopsy reports of unspecified or unclarified muscle pain syndromes should not be assumed to be those related to PFS, and such invalid references must be avoided.

Biopsy↗
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

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↗
PubMed1988

Current therapeutic practices in spondyloarthropathies.

Spondyloarthropathies are comprised of a number of diseases that have the following features in common: involvement of the spine with sacroiliitis, peripheral arthritis that is frequently asymmetric, absence of rheumatoid nodule, negative rheumatoid factor, and association with HLA-B27. The most important aspect of spondylitis management is a program of regular exercises, aided by nonsteroidal anti-inflammatory drugs (NSAIDs) and physical therapy. Indomethacin and phenylbutazone are most effective in AS and RS, although the latter drug should be used with care and only after a trial of other NSAIDs. The mainstay of peripheral arthritis management is the use of NSAIDs and intra-articular corticosteroids, but several delayed-acting drugs (gold, cytotoxic drugs) are beneficial in difficult cases, depending on the type and severity of the disease.

Anti-Inflammatory Agents, Non-Steroidal↗
PubMed1988

Diagnosis, etiology, and management of fibromyalgia syndrome: an update.

Recent controlled studies suggest a physiologic basis for FMS, which should be diagnosed by its own characteristic features and not by exclusion of other conditions alone. Diffuse musculoskeletal aching, accompanied by multiple TPs in the absence of an underlying arthritic or systemic condition, are the key features for diagnosis. Based on our controlled study, guidelines for diagnosis are provided in Table 5. Successful management of an FMS patient is often challenging, but frequently gratifying if approached with a positive and caring attitude. The most important aspects of management are a firm diagnosis, reassurance regarding the benign nature of the condition, help in changing patient behavior in order to accept pain and increase functional activities and exercise tolerance, and the use of tricyclic agents. Overall, management of fibromyalgia is an art that requires the combined ingredients of patience, understanding, and firmness in helping patients to assume responsibility for their pain management through behavior modifications.

Adult↗
PubMed1988

Primary fibromyalgia syndrome and myofascial pain syndrome: clinical features and muscle pathology.

Primary fibromyalgia syndrome (PFS) is a common form of nonarticular rheumatism with diffuse musculoskeletal aching and stiffness at multiple sites and tender points at characteristic locations. Nonmusculoskeletal "systemic" symptoms, eg, fatigue, poor sleep, irritable bowel symptoms, and chronic headaches, are also common. Although PFS is similar to myofascial pain syndrome (MPS) in that both conditions cause muscle pain and tenderness, important differences exist. Unlike PFS, muscle pain in MPS is usually local or regional, accompanied by trigger points. Unlike tender points, trigger points produce a referral pain pattern specific to each muscle. Moreover, "systemic" features of PFS are usually absent in MPS. Common and important pathologic changes in muscle in PFS are moth-eaten appearance of Type I fiber by histochemistry, and myofibrillar lysis with glycogen and mitochondria deposition by electron microscopy; inflammatory changes are absent by light microscopy. Recent investigations have shown that PFS is a characteristic clinical entity. Further controlled studies are, however, essential to establish the pathologic changes in tender muscles in PFS.

Adult↗
PubMed1986

Concepts of illness in populations as applied to fibromyalgia syndromes.

Fibromyalgia syndromes are common noninflammatory, painful musculoskeletal disorders that vary in the extent and intensity of involvement. The biologic gradient of musculoskeletal pain varies from no or few symptoms and tender points in the majority of persons to generalized fibromyalgia with multiple tender points. Standardized criteria are needed in order to categorize different strata of the biologic gradient of fibromyalgia syndromes and differentiate them from other conditions. Both the sensitivity and specificity of criteria should be high. The course and prognosis of fibromyalgia syndromes are not yet known. Limited clinical data suggest three basic patterns: remitting-intermittent; fluctuating-continuing; and progressive. However, course patterns need to be derived scientifically. Multiple host and environmental factors seem to contribute to the onset and course of fibromyalgia syndromes, and these require definition. Generalized fibromyalgia syndromes share many constitutional manifestations with other common functional disorders, e.g., irritable bowel syndrome and tension headache syndrome, which suggest common underlying psychoneurophysiologic mechanisms in a subset of patients. Progress made in fibromyalgia research will find application in many dysfunctional syndromes without obvious organ pathology.

Fibromyalgia↗
PubMed1986

Pathologic changes in muscle in primary fibromyalgia syndrome.

Primary fibromyalgia syndrome, also inappropriately called "fibrositis," is a clinically recognizable nonarticular rheumatic condition with diffuse and chronic musculoskeletal aching and stiffness, accompanied by exaggerated tenderness at characteristic sites on physical examination. Results of muscle biopsy from 12 well-defined cases of primary fibromyalgia syndrome without any history of trauma have been published recently. Light microscopic examination revealed no evidence of inflammation. Histochemical analysis demonstrated type II fiber atrophy in seven patients and the "moth-eaten" appearance of type I fibers in five patients. Electron microscopic findings were most impressive, and included myofibrillar lysis with deposition of glycogen and abnormal mitochondria, as well as subsarcolemmal accumulation of glycogen and mitochondria in all 12 patients and papillary projections of sarcolemmal membrane in 11 patients. Mechanisms of these significant muscle changes in primary fibromyalgia syndrome are uncertain but may include subclinical injury of muscle spasm.

Adolescent↗
PubMed1986

Serum beta-endorphin in primary fibromyalgia syndrome: a controlled study.

Serum beta-endorphin was assayed without knowledge of study subject category in 44 consecutive patients with primary fibromyalgia syndrome, 3 patients with rheumatoid arthritis (RA), and 30 normal controls, all females. Mean serum beta-endorphin levels were 81 +/- 28 pg/ml in patients with fibromyalgia, whereas those in normal controls and patients with RA were 73 +/- 17 pg/mg and 73 +/- 18 pg/ml, respectively. These differences were not statistically significant. Serum beta-endorphin levels did not correlate with relevant clinical variables in either fibromyalgia or RA groups.

Adolescent↗
PubMed1985

Juvenile primary fibromyalgia syndrome. A clinical study of thirty-three patients and matched normal controls.

Primary fibromyalgia syndrome (PFS) is a common and characteristic rheumatologic condition manifested by diffuse musculoskeletal aches, pains, and stiffness frequently modulated by various factors, e.g., weather, physical activity, sleep quality, and anxiety/stress, and accompanied by discrete tender points at typical soft tissue sites. Although well-recognized in adults, this entity has not been reported separately in juveniles. This study documents PFS in 33 juveniles who presented at age 17 or younger and compares their findings with those in age- and sex-matched normal control subjects. As in adult PFS patients, associated non-musculoskeletal symptoms were common, including fatigue, poor sleep, anxiety/stress, headaches, and paresthesias. Physical examination revealed multiple tender points at characteristic soft tissue sites and no objective evidence of arthritis. Routine laboratory test results were normal or negative. Juvenile PFS is often misdiagnosed. Recognition of this common rheumatologic condition in juveniles is important in order to avoid unwarranted investigations and improper management.

Absenteeism↗