2’’-O-Coumaroyljuglanin

9166001

OBJECTIVE?To investigate the relation between measures of pain threshold and symptoms of distress to determine if fibromyalgia is a discrete construct/disorder in the clinic.
METHODS?627 patients seen at an outpatient rheumatology centre from 1993 to 1996 underwent tender point and dolorimetry examinations. All completed the assessment scales for fatigue, sleep disturbance, anxiety, depression, global severity, pain, functional disability, and a composite measure of distress constructed from scores of sleep disturbance, fatigue, anxiety, depression, and global severity?the rheumatology distress index (RDI).
RESULTS?In regression analyses, the RDI was linearly related to the count of tender points (r2=0.30). Lesser associations were found between the RDI and dolorimetry measurements (r2=0.08). The RDI was more strongly correlated with the two measures of pain threshold than any of the individual fibromyalgia symptom variables. In partial correlation analyses, all of the information relating to symptom variables was contained in the tender point count, and dolorimetry was not independently related to symptoms.
CONCLUSION?Tender points are linearly related to fibromyalgia variables and distress, and there is no discrete enhancement or perturbation of fibromyalgia or distress variables associated with very high levels of tender points. Although fibromyalgia is a recognisable clinical entity, there seems to be no rationale for treating fibromyalgia as a discrete disorder, and it would seem appropriate to consider the entire range of tenderness and distress in clinic patients as well as in research studies. The tender point count functions as a `sedimentation rate’ for distress, and is a better measure than the dolorimetry score.

The relation between tender points and fibromyalgia symptom variables: evidence that fibromyalgia is not a discrete disorder in the clinic

F. Wolfe

1997 Apr

16623074

Although hypertension affects all racial and ethnic groups, its prevalence is highest in the African-American community. The goal of Healthy People 2010 is to reduce hypertension among African Americans from 40% to 16%. Although current levels remain high, culturally sensitive, community-based clinical projects might be helpful in addressing this problem. The goal of this study was to assess whether a community-based clinic’s program was effective in improving blood pressure control among a sample of 134 African-American adults. The program design involved health education and physical fitness classes offered over a nine-month period, with blood pressure checks being conducted pre- and postphases to determine whether the program was effective in controlling high blood pressure. Health questionnaires were also administered pre- and posttest to assess whether health behaviors and perceived health status were influenced by the project. Two-thirds (70%) of the sample had high blood pressure at baseline and 43% at program conclusion. This was a statistically significant difference (p=0.003). Overall self-reported health survey results indicated improved health behaviors and health status changes. Findings suggest that culturally sensitive, community-based clinic programs that incorporate both health education and physical fitness might be effective in reducing hypertension among African Americans.

Evaluating the impact of a hypertension program for African Americans.

Angelia M. Paschal, Rhonda K. Lewis, Arneatha Martin, Donna Dennis Shipp, Donna Sanders Simpson

2006 Apr