Normal concentrations of serum hyaluronic acid in patients with primary fibromyalgia syndrome.
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Biomarkers↗
Biomedical subjects
T Stratz
Publications and source records attributed to T Stratz.
[Intraindividual comparison of whole body cold therapy and warm treatment with hot packs in generalized tendomyopathy].
In a cross-over study, the short-term efficacy of whole-body cold therapy and hot mud packs in patients with generalized tendomyopathy (fibromyalgia) was compared. As a pain assessment, visual analog scale and so-called pain score were measured; dolorimetry of the 24 tender points and eight control points was performed as well. Using these methods, we found that there is a significant improvement of all parameters examined during a 2-h period of measurements after cold application, and a marked improvement was also detectable 24 h after this therapy. In contrast, only pain score values showed a slight decrease immediately after hot mud-pack therapy, and no significant differences were found in visual analog scale and pressure tenderness as measured dolorimetrically. Central inhibition of nociceptors as a result of an activation of A-delta system as well as a blockade of gamma-motoneurons are discussed to be a mechanism of action of whole-body cold therapy, resulting in a decrease in muscle tonus. Long-term studies are needed to determine, if there is any enduring effect of whole-body cold therapy on pain in the patients with generalized tendomyopathy.
Cryotherapy↗
[Comparative studies of the incidence of vegetative and functional disorders in backache and generalized tendomyopathies].
The incidence of 14 different vegetative and functional symptoms in patients with generalized tendomyopathy (fibromyalgia), chronic low back pain syndrome, and healthy controls was compared. The presence of these symptoms was a common finding in patients with generalized tendomyopathy. Although not so frequent, a number of these symptoms was also found in patients with chronic low back pain syndrome. Our findings suggest that presence of 7 or more symptoms is typical for generalized tendomyopathy and could be used as an additional criterium for diagnosis and classification of this disease. Further prospective studies are needed for confirming the hypothesis that chronic low back pain syndrome could lead to generalized tendomyopathy.
Adult↗
[Pressure point studies in generalized tendomyopathy (fibromyalgia) (comparison of various methods)].
There are different methods used for examination of tender-point pressure tenderness, which is one of the two most important criteria for diagnosis of generalised tendomypathy (fibromyalgia). When 11 of 18 tender points must be painful under the pressure of 4 kg for fulfilling the criteria of American College of Rheumatology (ACR), we require 12 of 24 points to be tender when pressed with a force less than 2 kg using dolorimeter. We have found that our method have a significantly higher specificity with about the same sensitivity, when compared with by ACR proposed method. Specificity and sensitivity depended on method used for pressure application and not on points examined. In view of our findings, we propose for scientific purposes dolorimetric measurement of pressure tenderness as being more reliable although more time-consuming method.
Adult↗
[Blocking of S2 receptors--a new treatment principle in generalized tendomyopathy (fibromyalgia)?].
In a pilot study, the effectiveness of the S2-receptor blocker ketanserin was investigated in patients receiving concurrent physiotherapy for primary fibromyalgia. This combined treatment was compared with physiotherapy alone. In the group treated with ketanserin, a significant reduction in spontaneous pain was observed, and the painfulness of "tender points" also decreased markedly. The patients experienced a significant improvement in the quality of sleep, the feeling of being rested after sleep, and psychological well-being in the evening. Significant improvement was also recorded on the Zerssen Mood Scale and the Erlanger Anxiety Scale. In the group receiving physiotherapy alone, the improvements were far less marked and usually were below the significance level. These results are now being verified in a double-blind, randomized trial.
Dose-Response Relationship, Drug↗
[Therapy of generalized tendomyopathy (fibromyalgia) caused by blocking 5-HT3 receptors].
In more than 40% of patients with fibromyalgia a marked influence on the pain in the skeletal system with a decrease of the tenderness at "tenderpoints" can be achieved by blocking the 5-HT3-receptors with ondansetron or tropisetron-hydrochloride. Physical complaints and vegetative signs also improve. It is discussed if patients not responding to therapy with ondansetron or tropisetron-hydrochloride have to be discriminated as a subgroup of fibromyalgia. More investigations are needed to confirm the described effects.
Acetaminophen↗
[A new measuring device for computer-assisted imaging of the form and flexibility of the spine].
Our aim is to present a new method to examine spinal mobility and spine shape excluding torsional scoliosis. In comparison to measuring devices of the spine used so far, this noninvasive and easy to use method documents altered patterns of intervertebral mobility of the lumbar and thoracic spine. This may lead to a broader application of the triflexometer as a diagnostic tool for orthopedic and rheumatologic diseases that can decrease the frequency of X-ray exposure if used in combination with radiographs. In the present investigation the triflexometer demonstrates a good reproducibility of the triflexometer-based measurements. These findings support the ability of the triflexometer to depict disease courses of spinal disorders as well as the effect of therapy and rehabilitation.
Humans↗
[Methods for detection of changes in muscle tonus].
Muscular spasm is a frequent symptom which is difficult to record precisely. On the basis of literature on the subject and of own studies, we undertook to describe various methods of examination which could be used to demonstrate such changes. Up to now, palpation is still the most important and most exact method for the experienced examiner. In this way local as well as extended muscular spasms can be made evident. The disadvantage however is the lack of objective proof. The easy-to-use Tissue-Compliance-Meter of Fischer, which measures the consistency of soft tissue, documents the intraindividual difference rather than the interindividual difference. This is due to the individually variable thickness of the subcutaneous fatty tissue. However, on the whole there is a good correlation to the findings of palpation. The pendulous-test and badismography allow especially the conclusion with regard to unilateral changes of tonus in the gluteal and upper leg muscles. This method also very well suits the intraindividual comparison, but less so the interindividual one. The continuous electromyogram is able to show the enhanced activity in spasmotic muscles also during sleep. The evaluation of enhanced muscle activity remains uncertain when using plain electromyogram. Recording of muscle tissue oxygen pressure is of little use to evaluate muscle spasm. Nonetheless, it provides interesting insights into pathogenetic questions. Thermography, measuring the blood circulation at the skin surface, is especially suited for perceiving intraindividual differences in case of muscle spasm. Nuclear magnetic resonance spectroscopy allows for noninvasive pH measurements in the muscle and therewith renders certain data concerning the degree of tension of this tissue. It is not yet suited for routine examination. The value of positron emission tomography for registering muscle spasm remains uncertain. Hopefully, this method, which documents the muscle energy metabolism, will enable us to more clearly evaluate muscle spasm than previous methods have done. Light and electron microscopic studies have provided contradictory results concerning histological changes in muscle biopsy in case of muscle spasm.
Adenosine Diphosphate↗
[Biochemical changes in fibromyalgia].
Different changes in neurotransmitters were observed in patients with fibromyalgia. The aim of the study was to confirm the diagnosis fibromyalgia by determination of several of these substances. In 60 patients, who met the ACR classification criteria for fibromyalgia and in 20 sex and age matched controls the following estimations were made: serotonin (EIA), somatomedin C (RIA), calcitonin (RIA), prostaglandin E2 (EIA), oxytocin (RIA), ACTH (RIA), substance P (EIA), TSH (LIA), prolactin (LIA). In comparison to healthy controls, patients with fibromyalgia revealed significantly decreased levels of serotonin, somatomedin C, calcitonin, prostaglandin E2 and a significantly increased level of prolactin. No significant differences were found in the levels of ACTH, substance P and TSH. These results suggest that the diagnosis of fibromyalgia can be confirmed by various biochemical parameters, but further investigations must be carried out to value the diagnostic relevance of these findings.
Adrenocorticotropic Hormone↗
The 5-HT3 blockers in the treatment of the primary fibromyalgia syndrome: a 10-day open study with Tropisetron at a low dose.
A 10-day open trial with Tropisetron, the selective serotonin type 3 receptor antagonist, in a dose of 5 mg daily was undertaken in 19 patients with the primary fibromyalgia syndrome (FB). Before and after the therapy, pain was assessed using a visual analogue scale and a pain score. All the patients were asked about the presence and intensity of vegetative and functional symptoms. Moreover, the tenderness at the 24 typical tender points at baseline and at the end of the therapy was evaluated. A statistically significant improvement of all examined parameters was observed after the therapy. The efficacy of Tropisetron in a dose of 5 mg daily was comparable with the results obtained in a previously reported trial with a dose of 10 or 15 mg per day, but the frequency of gastric troubles decreased (21% vs. 60%). The hypothesis about the existence of two subgroups of patients with FB is also discussed.
Adult↗