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Biomedical subjects

M B Yunus

Publications and source records attributed to M B Yunus.

43 records · Page 3Linked to original sources

Psychological factors associated with primary fibromyalgia syndrome.

Forty-five ambulatory patients with primary fibromyalgia syndrome (PFS), 30 with rheumatoid arthritis, and 32 normal controls were administered 3 psychological tests: the Minnesota Multiphasic Personality Inventory (MMPI), the Life Events Inventory, and the Assertiveness-Aggressiveness Inventory. The PFS patients scored significantly higher on 8 MMPI scales when compared with the normal control group and on 4 MMPI scales when compared with the rheumatoid arthritis group. Further subgrouping of PFS patients according to MMPI scores showed that only 31% were "psychologically disturbed," 33% had a typical chronic pain profile, and 36% were within the normal range. The PFS patients scored higher than the rheumatoid arthritis and normal control groups on the Life Events Inventory but not the Assertiveness-Aggressiveness Inventory.

Adolescent↗

Primary fibromyalgia syndrome: current concepts.

PFS is a characteristic and clinically recognizable rheumatologic syndrome. It is a very common condition, but only recently has investigational interest grown in this interesting syndrome. PFS should be diagnosed by its own characteristic features and not merely by excluding other conditions. Pathophysiology of PFS is not well understood at this time and needs further study. Sleep EEG studies in PFS have revealed disturbed non-REM sleep, and normal volunteers deprived of non-REM sleep develop many features of non-REM sleep develop many features of PFS, including musculoskeletal aching, tenderness, and fatigue. Psychologic studies have shown that only a subset of PFS patients have shown that only a subset of PFS patients are significantly disturbed as determined by MMPI scores, and PFS patients as a group are more stressed than RA patients and normal controls as measured by Holmes-Rahe Life Events Inventory. It appears that chronic anxiety-stress causes muscle spasm that can be appreciated clinically in some patients and indirectly, possibly by electron microscopic findings of muscle biopsy. Likely role of other factors, e.g., constitutional, trauma, posture, and weather are also discussed. Biochemical transmitters of pain remain to be studied in PFS. Lack of a specific physical or laboratory finding should not deter acceptance of PFS as an entity, since such specific findings are absent in other similar and well-accepted conditions, e.g., irritable bowel syndrome, with which PFS shares many other common features, including muscle tenderness and spasm. PFS is different from psychogenic pain, and any implication by a physician that it is "all in the head" is certain to perpetuate chronic pain and disability.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Muscle pathology in primary fibromyalgia syndrome: a light microscopic, histochemical and ultrastructural study.

Upper medial trapezius muscle biopsy was obtained from 12 primary fibromyalgia syndrome (PFS) patients (age 17 to 40 years) and studied with histochemistry, light and electron microscopy (EM). No evidence of inflammation was found in any case. Significant histochemical abnormalities were Type II fiber atrophy in 7 and moth-eaten appearance of Type I fibers in 5. EM revealed segmental muscle fiber necrosis with lipid and glycogen deposition as well as subsarcolemmal mitochondrial accumulation in all cases. Papillary projections of sarcolemmal membrane were seen in 11 patients. These observations in 12 PFS cases without obvious muscle trauma indicate definite but nonspecific muscle changes which we suspect are secondary to chronic muscle spasm and ischemia of unknown etiology.

Adolescent↗

Aortic regurgitation in scleroderma.

Two cases of scleroderma with isolated aortic regurgitation are described. Other known causes of aortic regurgitation were not apparent. None of the patients gave a history of rheumatic fever. It appears likely that aortic regurgitation is related to scleroderma in these two patients. Aortic regurgitation in scleroderma is, however, rare.

Adult↗

Primary fibromyalgia syndrome: a critical evaluation of recent criteria developments.

Although nonspecific musculoskeletal aching of nonarticular origin has been described in European literature since the 17th century under such names as muscular rheumatism, the fibrositis syndrome with generalized musculoskeletal aches or stiffness, fatigue, poor sleep, and multiple tender points as a characteristic rheumatologic entity was not described until the 1960s. Smythe first suggested criteria for this condition based on clinical experience in the 1970s. However, the first data-based criteria of "fibrositis" (appropriately called fibromyalgia) was not published until 1981. Since then other criteria have been published, and in 1989 criteria studies on fibromyalgia with appropriate design and controls were reported. This article critically evaluates current criteria developments in fibromyalgia.

Diagnosis, Differential↗

Preliminary criteria for primary fibromyalgia syndrome (PFS): multivariate analysis of a consecutive series of PFS, other pain patients, and normal subjects.

Primary fibromyalgia syndrome (PFS) is a common form of nonarticular rheumatism with chronic and generalized musculoskeletal aching and stiffness, accompanied by tender points at characteristic sites in the absence of an underlying condition. No satisfactory criteria for its diagnosis, based on appropriate controlled studies, have yet been proposed. We undertook such a study which included a consecutive series of clinically diagnosed PFS and compared them with 3 control groups--mild rheumatoid arthritis, localized fibromyalgia secondary to trauma and normal controls. Multivariate statistical analysis plus clinical judgement identified 6 historical features and 7 pairs of tender points that best discriminated PFS from the control groups. The criteria, derived from a combination of these historical features and tender points, provided greater than 90% sensitivity and specificity. In an independent and consecutive sample of 45 PFS patients, the criteria yielded a sensitivity of 89%. The present study indicates that a combination of historical features and TP's will likely provide effective PFS criteria.

Adult↗