This review has focused on important but less visible aspects of fibromyalgia (FM) with respect to the high impact of this disorder on patients and societies. FM is a common but challengeable illness. It is characterized by chronic widespread pain, which can be accompanied by other symptoms including fatigue, sleep disturbances, cognitive dysfunction, anxiety and depressive episodes. While our understanding of this debilitating disorder is limited, diagnosis and treatment of this condition is very difficult, even in the hands of experts. Due to the nature of disease, where patients experience invalidation by medical services, their families and societies regarding the recognition and management of disease, direct, indirect and immeasurable costs are considerable. These clinical and economic costs are comparable with other common diseases, such as diabetes, hypertension and osteoarthritis, but the latter usually receives much more attention from healthcare and non-healthcare resources. Present alarming data shows the grave and "iceberg-like" burden of FM despite the benign appearance of this disorder and highlights the urgent need both for greater awareness of the disease among medical services and societies, as well as for more research focused on easily used diagnostic methods and target specific treatment.
The purpose of this study was to compare differences in endurance time and EMG power spectral characteristics of the masticatory muscles during sustained isometric contraction between patients and controls. 15 CMD patients{8 women and 7 men, aged 15 to 38 years(24.1$\pm$7.5)}, and 15 healthy volunteers{8 women and 7 men, aged 15 to 30 years(24.7$\pm$3.4)} without past history or present symptoms of CMD were included in this study. Sustained isometric contractions of masticatory muscles were perfomeed as long as possible at 50% level of maximum voluntary contraction(MVC) of EMG activity via visual feedback, and the duration of sustained isometric contraction(endurance time) was examined. The author perfomed EMG power spectral analysis in the myoelectric signals of masseter and anterior temporal muscle during sustained isometric contraction in CMD patients with chronic muscle pain and healthy controls. The author came to following conclusions from the results. 1. The endurance time of the patient group was shorter than the control group in sustained isometric contraction of masticatory muscles(p<0.01). 2. MF values of masticatory muscles with sustained isometric contraction during endurance time were decreased following regression line in both groups(p<0.01, r>0.9). 3. The amount of MF shift to lower frequency range exhibited no significant differences between the patients and the control group in sustained isometric contraction during endurance time. 4. SMF to lower frequency range of the patient group was steeper than the control group in sustained isometric contraction during endurance time(p<0.05).
Kim Jin-Man;Han Jung-Suk;Lee Sun-Hyung;Yang Jae-Ho;Lee Jae-Bong;Kim Yung-Soo
The Journal of Korean Academy of Prosthodontics
/
v.41
no.4
/
pp.519-531
/
2003
Statement of problem : Chronic implant screw loosening remains a problem in restorative practices. Some implant manufactureres have introduced abutment screws with treated material, surfaces and macrostructures in an effort to reduce potential loosening. Purpose : This study evaluated the materials and loading cycles on detorque value after dynamic continous fatigue test in the sinulated conditions of posterior single restoration. Material and method : Fourteen of each of the following abutment screws - titanium alloy, gold alloy, gold-tite, and titanium alloy modified - were used in test. SEM is used to verify macrostructures of each screws. $ZrO_2/Al_2O_3$ composite abutment was tightened on $4{\times}10.0mm$ titanium external implant at 30 Ncm. Cyclic loading machine delivered dynamic loading forces between 20 and 320N for 100,000, 200,000, 300,000, 500,000, and 1,000,000 cycles at frequencies 14Hz. Torque and detorque value after loading was measured. Results : All measued screws had different screw length and thread form. Titanium modified screw had greater detorque value than others before and after cyclic loadings(p<0.05). All abutment screws had no significant change in mean percentage of detorque value after loading to initial value after less than 500.000 cyclic loadings, but significant lower value after 1,000,000 cycles(p<0.05). Conclusion : Within limintations of this study all abutment screws may be loosend after about 1 year use. Annual check-up is nessasary to prevent screw loosening.
Kim, Keum-Soon;Yu, Jeong-A;Kim, Jin-A;Lee, Yim-Sun;Lee, In-Ok
Journal of muscle and joint health
/
v.17
no.1
/
pp.68-78
/
2010
Purpose: This study was conducted to determine the effects of Tai-Chi exercise and self-help management program applying laughter therapy in patients with osteoarthritis. Methods: This quasi-experimental study recruited a sample of 61 patients with osteoarthritis (experimental group: 30, control group: 31) through the community healthcare centers located in Seoul and Kyung Gi area. The primary outcome measures included symptoms of osteoarthritis, basic physical performance, fatigue, and depression assessed before and after the study. The data were analyzed using SPSSWIN V. 12.0. Results: At the end of the six-week intervention, left shoulder flexibility (t=2.011, p=.049), 6m walking speed (t=3.639, p=.001), and right balance (t=-2.30, p=.025) were significantly improved in the control group. Fatigue (t=3.012, p=.004), stiffness (t=2,093, p=.041), right shoulder flexibility (t=2.138, p=.037), right balance (t=-2.065, p=.043), and 6m walking speed (t=2.683, p=.009) were significantly improved in the experimental group. Conclusion: A twice a week, 6-week tai-chi exercise self-help management program applying laughter therapy is effective in decreasing fatigue and stiffness. Osteoarthritis is one of common chronic diseases that the patients should be required to continue self management for the rest of their life. Therefore, there is a need to develop the more effective self-help management program and nursing intervention to motivate them to maintain their own self-help management.
Background: We aimed to explore the American College of Rheumatology (ACR) 1990 and 2011 fibromyalgia (FM) classification criteria's items and the components of Fibromyalgia Impact Questionnaire (FIQ) to identify features best discriminating FM features. Finally, we developed a combined FM diagnostic (C-FM) model using the FM's key features. Methods: The means and frequency on tender points (TPs), ACR 2011 components and FIQ items were calculated in the FM and non-FM (osteoarthritis [OA] and non-OA) patients. Then, two-step multiple logistic regression analysis was performed to order these variables according to their maximal statistical contribution in predicting group membership. Partial correlations assessed their unique contribution, and two-group discriminant analysis provided a classification table. Using receiver operator characteristic analyses, we determined the sensitivity and specificity of the final model. Results: A total of 172 patients with FM, 75 with OA and 21 with periarthritis or regional pain syndromes were enrolled. Two steps multiple logistic regression analysis identified 8 key features of FM which accounted for 64.8% of variance associated with FM group membership: lateral epicondyle TP with variance percentages (36.9%), neck pain (14.5%), fatigue (4.7%), insomnia (3%), upper back pain (2.2%), shoulder pain (1.5%), gluteal TP (1.2%), and FIQ fatigue (0.9%). The C-FM model demonstrated a 91.4% correct classification rate, 91.9% for sensitivity and 91.7% for specificity. Conclusions: The C-FM model can accurately detect FM patients among other pain disorders. Re-inclusion of TPs along with saving of FM main symptoms in the C-FM model is a unique feature of this model.
Background: Patients with chronic liver diseases (CLD) may have compromised health related quality of life (HRQoL). Hepatitis B virus (HBV) infection has long been the leading cause of CLD including liver cancer and cirrhosis. Knowledge on different symptom profiles of CLD should help in development of comprehensive treatment and patient care plans. Objective: To access the facets of HRQoL in chronic liver diseases throughout their spectrum of severity. Materials and Methods: A cross-sectional study was conducted in the First Affiliated Hospital of Kunming Medical University in Yunnan Province of China. Both out- and inpatients undergoing treatment protocols for different HBV related liver disease states were consecutively collected from December 2012 to June 2013. ANOVA was used to compare the mean scores of EQ-5D and chronic liver disease questionnaire (CLDQ) among 5 disease groups. The relationship between demographic variables predicting global CLDQ scores and the domains of CLDQ was analysed. Results: A total of 1040 patients including 520 without complications, 91 with compensated cirrhosis, 198 with decompensated cirrhosis, 131 with HCC and 100 with liver failure were recruited. All domains of CLDQ, the means of EQ-5D value and EQ VAS exhibited significant decline with worsening of disease severity from uncomplicated HBV to liver failure. The multivariate regression demonstrated the reduction of mean scores of CLDQ domain at advanced stage. Patients with liver failure and HCC had more HRQoL impairment than other disease states. No effect of patient gender was found. Patient age was associated with 'fatigue' and 'worry' domains (p=0.006; p=0.004) but not with other domains and global scores of CLDQ and ED-5D. Conclusions: The HRQoL in chronic hepatitis B patients is greatly affected by disease states. Care for HBV-related diseases should consider not only the outcomes of treatment strategies but also improvement in patient wellbeing.
Objective: This study was designed to analyze the symptoms of chronic obstructive pulmonary disease (COPD) patients who attended a Korean medicine hospital and treatment effects through retrospective chart reviews.Methods: The medical records of 192 outpatients who had been diagnosed with COPD and visited the Allergy, Immune, and Respiratory System Department of Kyung Hee Korean Medicine Hospital from 1 February 2006 to 1 February, 2016 were retrospectively reviewed.Results: The study group consisted of 112 and 80 females. The median age of the patients was 59.80±15.46 y. Fifty of the patients had been diagnosed with chronic upper respiratory diseases, such as chronic rhinitis, nasopharyngitis, or sinusitis. The chief complaints were cough (n=136), sputum (n=124), and dyspnea (n=82). Other frequent symptoms were fatigue (n=11), hyperhidrosis (n=8), and a bad taste in the mouth (n=7). All the patients were prescribed Korean herbal medicine. In the study, 61 (31.77%) patients were treated with acupuncture, moxibustion, cupping therapy, or herbal steam therapy. Symptoms improved in 126 (65.63%) patients 141±272.82 d after the first treatment.Conclusions: Some of the COPD patients had chronic upper respiratory disease. The chief complains were cough, sputum, and dyspnea. Oher frequent symptoms related to body malfunction and pain. The symptoms improved in 126 (65.63%) patients 141.00±272.82 d post-treatment.
The aim of this study was to compare pain descriptions in common dental patients with those in patients with Temporomandibular disorders(TMDs). The study sample consisted of 104 common dental patients and 74 patients with TMDs, and their chief complaint was pain, Subjects were classified common dental pain group and TMDs pain group, respectively. All the subjects completed Korean Pain Rating Scale(KPRS) on first visit. KPRS contains 90 pain terms, which divided into 20 subclasses in 3 dimensions. Each subclass contains 3-6 pain terms. each patient had chosen only one term from each subclass. If there was no proper term, subject could pass the subclass without completion. Words chosen were categorized into sensory, affective, miscellaneous and total dimension. Thereafter they were processed and analyzed by SPSS/PC+ statistical package program with respect to rank values, scale values, number of words chosen and frequency of each subclass. The obtained results of this study were as follows : 1. Total mean number of words chosen was 7.6. 2. Chronic patients groups with Temporomandibular disorders had chosen more freuently from the subclasses in affective dimension than the patients in acute common dental pain group. 3. Frequency of affective dimension was higher in chronic patients groups with Temporomandibular disorders than that of acute patients group with Temporomandibular disorders. 4. Chronic patients group with Temporomandibular disorders had higher frequency in constrictive pressure pain, traction pressure pain, dull pain and fatigue-related pain terms than acute common dental patients group. 5. Acute patients group with Temporomandibular disorders had higher frequency in traction pressure pain and dull pain terms but had lower frequency in chemical pain, peripheral nerve pain and cold pain terms than acute common dental patients groups. 6. There were high positive correlation between the scale- and rank-value in the pain rating index.
Objectives: This study is aimed at assessing the reliability of a standard instrument of diagnosis and assessment for Spleen Qi deficiency pattern questionnaire (SQDQ) and examining the validity of the SQDQ by comparing the pattern identification scores of different groups. Methods: We conducted a survey of 72 participants (60 patients with chronic dyspepsia and 12 healthy subjects) using self-reported questionnaire. Participants were given written consent and this study was performed under the permission of institutional review board of Kyung-Hee university Korean medicine hospital. Results: The reliability and the validity of the questionnaire were inspected. Internal consistency of the SQDQ was excellent. Construct validity analyzed by exploratory factor analysis produced 4 factors, which were selected from eigenvalues that are greater than 1.0. The factor 1, 2, 3 and 4 showed 'fatigue', 'meal', 'diagnosis' and 'figure' respectively. For most of SQDQs' items, there were significant differences observed between the Spleen Qi and the non-Spleen Qi groups. However, the 'emaciation', 'tongue diagnosis' and 'pulse diagnosis' showed no significant differences. Conclusions: The SQDQ restructured in this study may provide a fundamental questionnaire and a further study is required for a more advanced, standardized and statistically proven questionnaire.
Globally, cardiovascular diseases and chronic obstructive pulmonary disease (COPD) are the leading causes of the non-communicable disease burden. Overlapping symptoms such as breathing difficulty and fatigue, with a lack of awareness about COPD among physicians, are key reasons for under-diagnosis and resulting sub-optimal care relative to COPD. Much has been published in the past on the pathogenesis and implications of cardiovascular comorbidities in COPD. However, a comprehensive review of the prevalence and impact of COPD management in commonly encountered cardiac diseases is lacking. The purpose of this study was to summarize the current knowledge regarding the prevalence of COPD in heart failure, ischemic heart disease, and atrial fibrillation. We also discuss the real-life clinical presentation and practical implications of managing COPD in cardiac diseases. We searched PubMed, Scopus, EMBASE, and Google Scholar for studies published 1981-May 2020 reporting the prevalence of COPD in the three specified cardiac diseases. COPD has high prevalence in heart failure, atrial fibrillation, and ischemic heart disease. Despite this, COPD remains under-diagnosed and under-managed in the majority of patients with cardiac diseases. The clinical implications of the diagnosis of COPD in cardiac disease includes the recognition of hyperinflation (a treatable trait), implementation of acute exacerbations of COPD (AECOPD) prevention strategies, and reducing the risk of overuse of diuretics. The pharmacological agents for the management of COPD have shown a beneficial effect on cardiac functions and mortality. The appropriate management of COPD improves the cardiovascular outcomes by reducing hyperinflation and preventing AECOPD, thus reducing the risk of mortality, improving exercise tolerance, and quality of life.
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