FM/CFS/ME RESOURCES - Medical Definitions

 

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MEDICAL DEFINITIONS FM/CFS/ME RESOURCES

Whether you're new to FM and/or CFS/ME, or an experienced patient, there are always new terms and terminologies coming up. In order to find the medical information you're looking for, you'll come across medical terminology and medical information you might not understand.

This page contains over 200 definitions listed below, with many new words added monthly. The words are listed in alphabetical order. You can either select a letter from the box below, or scroll down the page to reveal the word you're looking for.

Contact us if you cannot locate a specific definition.

A
B
C
D
E
F
G
H
I
J
K
L
M
N
O
P
Q
R
S
T
U
V
W
X
Y
Z


A

Abnormalities
ACE Inhibitor
Acidosis
Acid Reflux (GERD)
Acute
Acupressure
Acupuncture
Acute Respiratory Distress Syndrome
Adipose Tissue
Adipocytes
Adrenocorticotropic Hormone
Agnosia
Allergy
Allodynia
Alpha EEG Anomaly
Alzheimer's Disease
Anemia
Angina
Ankylosing Spondylitis
Anti-Anxiety Medication
Antibiotics
Anticardiolipin Antibodies
Antidepressant
Anxiety
Aphasia
Apraxia
Asymptomatic
Atheroma
Autoimmune Diseases
Autonomic Nervous System

B

Balneotherapy
Benign Prostatic Hyperplasia
Benzodiazepine
Berylliosis
Biofeedback
Broca's Area
Bruxism

C

Cardiac Arrhythmia
Cardiomyopathy
Carpal Tunnel Syndrome
Catastrophizing
Catecholamine
Celiac Disease
Central Sensitization
Central Nervous System
Cerebral Palsy
Cerebrospinal Fluid
Cervical Spinal Stenosis
Channelopathies
Chiari Malformation
Chiropractic
Chronic
Chronic Fatigue Syndrome
Clinical
Coagulopathy
Cognitive
Cognitive Behavior Therapy
Cognitive Therapy
Colostomy
Comorbidity
Condition
Connotes
Cortisol
Costochondral Junction
Costochondritis
Crohn's Disease
Curettage
Cushing's Syndrome
Cyanosis
Cytokines
Cytomegalovirus

D

Deamination
Debilitating
Depression
Diabetes Mellitus
Disease
Disseminated
Dopamine
Dopaminergics
Double-Blind, Placebo-Controlled Clinical Trial
Dysarthria
Dysbiosis
Dysfunction
Dysmenorrhea
Dyspepsia
Dysphoria
Dyspnea

E

EEG Neurotherapy
Electrocardiogram
Electromyography
Endogenous
Endometriosis
Endotracheal Tube
Enteroviruses
Epigallocatechin Gallate (EGCG)
Epilepsy
Epstein-Barr Virus
Etiology
Etymologically
Exacerbate
Excitatory
Exertion

F

Fascia
Fatigue
Fibro-Fog
Fibromyalgia
Flare or Flare-up

G

GABA
Gastrointestinal
Genetic Predisposition
Generalized Anxiety Disorder
Glia
Glutamate
Granulocytes
Granuloma
Greater Trochanter
Growth Hormone

H

Hashimoto's Thyroiditis
Headache
Hepatitis
Holistic
Herpes Simplex Virus
Homeopathy
Homeostasis
Hormone
Hydrotherapy
Hyperalgesia
Hyperhidrosis
Hyperparathyroidism
Hypochondria
Hypocretin
Hypoglycemia
Hyponatremia
Hypothalamic-Pituitary-Adrenal - HPA Axis
Hypothalamus
Hypothyroidism
Hypoxemia

I

Immune
Immune System
Immunological
Incontinence
Infection
Insulin
Interphalangeal
Interstitial Cystitis
Intravascular
Irritable Bowel Syndrome

J

Joint

K

Ketoacidosis

L

Lability
Latent
Lateral Epicondyle
Leukemia
Levothyroxine
Ligament
Liothyronine
Lipoma
Low Levels of Cytokines
Lupus
Lyme Disease

M

Malaise
MAOI's
Magnet Therapy
Massage Therapy
Melatonin
Methocarbamol
Microvascular Disease
Migraines
Mitochondrial
Mitogen
Mitral Valve Prolapse
Mononucleosis
Morton's Neuroma
Multiple Chemical Sensitivity
Multiple Sclerosis
Muscle
Muscle Relaxers
Musculoskeletal Disorders
Myalgic Encephalomyelitis
Myasthenia Gravis
Mycoplasma Fermentans
Myositis

N

Narcolepsy
Narcotics
Natural Killer (NK) Cells
Naturopathy
Neoplasia
Neuroendocrine
Neurological
Neurotransmitters
Neurotransmitter Dysregulation
New Drug Application (NDA)
Nociceptor
Norepinephrine
NSAID's

O

Occupational Therapy
Orthostatic Intolerance
Osteopathic Medicine
Osteoarthritis
Osteoporosis

P

Pain Medication
Pain Threshold
Pain Tolerance
Parkinson's Disease
Pathology
Paresthesia
Periphery
Peritoneal Lavage
Peptides
Peripheral Neuropathy
Pertussis
Phenotype
Physical Therapy
Physiological
Plateau
Polymyalgia Rheumatica (PMR)
Polymyositis
Polypeptide
Polyphenols
Post-Exertional Malaise
Postural Orthostatic Tachycardia Syndrome
Primary Sleep Disorders
Progressive
Psoriasis
Psoriatic Arthritis
Psychoneuroimmunology
Precipitate
Post-Viral Fatigue Syndrome
Prohormone

R

Raynaud's Phenomenon
Reflex Sympathetic Dystrophy
Rehabilitation
Relapse
Relaxation Techniques
Remission
Restless Leg Syndrome
Resuscitate
Retroviruses
Reye's Syndrome
Rheumatoid Arthritis
RNase L
Rule Out

S

Sarcoidosis
Scapula
Scleroderma
Seasonal Affective Disorder
Semispinalis Capitis
Serotonin
Serotonin Syndrome
Sign
Sinusitis
Sjögren's Syndrome
Skeletal Muscles
Sleep Apnea
Sleep Medication
SNRI's
SPECT
Splenius Capitis
Sporadically
SSRI's
Sternocleidomastoid Muscle
Stress
Substance P
Supraspinatus Muscle
Supine Position
Symptom
Syndrome
Systemic

T

Tachycardia
Tai Chi
T Cells
Temporal Arteritis
Temporomandibular Joint Syndrome
Tendon
Tender Points
Testosterone
Thalamus
Therapeutic
Therapy
Thorax
Thrombosis
Thyroid
Thyroid Disease
Tinnitus
Tomography
Transverse Processes
Trapezius Muscle
Tricyclic Antidepressants
Tuberculosis

U

Urea
Uveitis

V

Vasopressin Metabolism
Vertigo
Virus

W

X

XAND
Xenotropic
XMRV

Y & Z

Yeast Infections
Yoga

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Occupational Therapy

Occupational therapy (OT) is rehabilitation of mentally and physically disabled persons by teaching them a skill or providing them with creative activity. OT gives people the "skills for the job of living" necessary for living meaningful and satisfying lives.

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Orthostatic Intolerance

Orthostatic intolerance is the failure of the body to properly adjust to an upright position, especially with respect to blood flow, heart rate, and blood pressure.

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Osteopathic Medicine

Osteopathic Medicine is an approach to manual therapy used to improve the impaired or altered function of the musculoskeletal system (somatic dysfunction).

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Osteoarthritis

Osteoarthritis is a type of arthritis that is caused by the breakdown and eventual loss of the cartilage of one or more joints. Cartilage is a protein substance that serves as a "cushion" between the bones of the joints. Osteoarthritis is also known as degenerative arthritis. Among the over 100 different types of arthritis conditions, osteoarthritis is the most common, affecting over 20 million people in the United States. Osteoarthritis occurs more frequently as we age. Before age 45, osteoarthritis occurs more frequently in males. After age 55 years, it occurs more frequently in females. In the United States, all races appear equally affected. A higher incidence of osteoarthritis exists in the Japanese population, while South African blacks, East Indians, and Southern Chinese have lower rates.

Osteoarthritis commonly affects the hands, feet, spine, and large weight-bearing joints, such as the hips and knees. Most cases of osteoarthritis have no known cause and are referred to as primary osteoarthritis. When the cause of the osteoarthritis is known, the condition is referred to as secondary osteoarthritis. Osteoarthritis is sometimes abbreviated OA.

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Osteoporosis

Osteoporosis is a disease that causes your bones to become thin and brittle. This leaves you at a high risk of developing bone fractures or breaks that could end up causing you even more pain and disability. As you grow, you gradually lose bone mass throughout your body. This bone mass is typically replaced, in order to keep you healthy and strong. As you age though, bone replacement can’t keep up with bone loss. Osteoporosis only adds to this bone loss, increasing the likelihood that you will suffer from painful fractures in areas like your hip, wrists, and spine. Osteoporosis does get worse over time, so it is essential that you find appropriate treatment from your health care provider.

Fibromyalgia seems to be associated with osteoporosis. A large percentage of fibromyalgia patients suffer from decreased bone mass, leading to bone fractures. A variety of studies have been performed on this topic. In these studies, Fibromyalgia sufferers show lower-than-normal bone mass in their necks, spinal columns, and hips. This is particularly true if you have fibromyalgia and are between the ages of 51 and 60.

It is thought that fibromyalgia sufferers get osteoporosis because of reduced growth hormones. Fibromyalgia syndrome suppresses the production of growth hormone, thus limiting the production of bone. As a result, bones become very fragile and osteoporotic.

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Pain Medication

Pain medications (analgesics) are not all the same. Each pain medication has its advantages and risks. Specific types of pain may respond better to one kind of medication than to another kind. Each person may have a slightly different response to a pain medication.

Over-the-counter medications are good for many types of pain. Acetaminophen (Tylenol) is good for relieving pain and fever. It is less irritating to the stomach than other over-the-counter pain medications and is safer for children. It can, however, be toxic to the liver if you take more than the recommended dose.

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Pain Threshold

The pain threshold is the point at which sensation becomes pain. For example, imagine someone is tapping on your arm and taps progressively harder. Eventually, the tapping will become hard enough to hurt, and that is when it has reached your pain threshold.

Pain thresholds vary from person to person and are abnormally low in fibromyalgia (FM). That's why things that aren't painful to most people can cause pain in those with FM. Some research also suggests low pain thresholds are a part of chronic fatigue syndrome, and at least one study shows that pain thresholds drop following exercise for people with this condition.

Pain threshold is distinctly different from pain tolerance.

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Pain Tolerance

Pain tolerance is the amount of pain a person can handle without breaking down, either physically or emotionally.

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Parkinson's Disease

Parkinson's disease is a disorder of the brain that leads to shaking (tremors) and difficulty with walking, movement, and coordination.

Parkinson's disease most often develops after age 50. It is one of the most common nervous system disorders of the elderly. Sometimes Parkinson's disease occurs in younger adults. It affects both men and women.

In some cases, Parkinson's disease occurs in families. When a young person is affected, it is usually because of a form of the disease that runs in families.

Nerve cells use a brain chemical called dopamine to help control muscle movement. Parkinson's disease occurs when the nerve cells in the brain that make dopamine are slowly destroyed. Without dopamine, the nerve cells in that part of the brain cannot properly send messages. This leads to the loss of muscle function. The damage gets worse with time. Exactly why these brain cells waste away is unknown.

Parkinson's in children may occur because the nerves are not as sensitive to dopamine. Parkinson's is rare in children.

The term "parkinsonism" refers to any condition that involves the types of movement changes seen in Parkinson's disease. Parkinsonism may be caused by other disorders (such as secondary parkinsonism) or certain medications.

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Pathology

The study of disease. Pathology has been defined as "that branch of medicine which treats of the essential nature of disease." A medical doctor that specializes in pathology is called a pathologist. Pathologists are experts at interpreting microscopic views of body tissues.

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Paresthesia

Paresthesia is a sensation of tingling, pricking, or numbness of a person's skin with no apparent long-term physical effect, more generally known as the feeling of pins and needles or of a limb being "asleep". Numbness or tingling, particularly in the hands or feet, sometimes accompanies FM and/or CFS/ME.

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Periphery

A boundary or outer part of any space or body.

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Peptides

Peptides are the family of short molecules formed from the linking, in a defined order, of various a-amino acids. The link between one amino acid residue and the next is an amide bond and is sometimes referred to as a peptide bond.

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Peritoneal Lavage

Diagnostic peritoneal lavage is performed when intra-abdominal bleeding usually secondary to trauma is suspected. Nowadays Diagnostic peritoneal lavage is largely abandoned in favor of abdominal ultrasound.

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Peripheral Neuropathy

Peripheral neuropathy is the term for damage to nerves of the peripheral nervous system, which may be caused either by diseases of the nerve or from the side-effects of systemic illness.

The four cardinal patterns of peripheral neuropathy are:

  • polyneuropathy
  • mononeuropathy
  • mononeuritis multiplex
  • autonomic neuropathy

The most common form is (symmetrical) peripheral polyneuropathy, which mainly affects the feet and legs. The form of neuropathy may be further broken down by cause, or the size of predominant fiber involvement, i.e., large fiber or small fiber peripheral neuropathy. Frequently the cause of a neuropathy cannot be identified and it is designated idiopathic.

Neuropathy may be associated with varying combinations of weakness, autonomic changes, and sensory changes. Loss of muscle bulk or fasciculations, a particular fine twitching of muscle, may be seen. Sensory symptoms encompass loss of sensation and "positive" phenomena including pain.

Symptoms depend on the type of nerves affected (motor, sensory, or autonomic) and where the nerves are located in the body. One or more types of nerves may be affected. Common symptoms associated with damage to the motor nerve are:

  • muscle weakness
  • cramps
  • spasms

Loss of balance and coordination may also occur. Damage to the sensory nerve can produce tingling, numbness, and pain. Pain associated with this nerve is described in various ways such as the following: sensation of wearing an invisible "glove" or "sock", burning, freezing, or electric-like, extreme sensitivity to touch. The autonomic nerve damage causes problems with involuntary functions leading to symptoms such as abnormal blood pressure and heart rate, reduced ability to perspire, constipation, bladder dysfunction (e.g., incontinence), and sexual dysfunction.

The causes are broadly grouped as follows:

  • Genetic diseases: Friedreich's ataxia, Charcot-Marie-Tooth syndrome
  • Metabolic/Endocrine: diabetes mellitus, chronic renal failure, porphyria, amyloidosis, liver failure, hypothyroidism
  • Toxic causes: Drugs (vincristine, phenytoin, nitrofurantoin, isoniazid, ethyl alcohol), organic metals, heavy metals, excess intake of vitamin B6 (pyridoxine)
  • Fluoroquinolone toxicity: Irreversible neuropathy is a serious adverse reaction of fluoroquinolone drugs
  • Inflammatory diseases: Guillain-Barré syndrome, systemic lupus erythematosis, leprosy, Sjögren's syndrome
  • Vitamin deficiency states: Vitamin B12 (cyanocobalamin), vitamin A, vitamin E, vitamin B1 (thiamin)
  • Physical trauma: compression, pinching, cutting, projectile injuries (i.e. gunshot wound), strokes including prolonged occlusion of blood flow
  • Others: shingles, malignant disease, HIV, radiation, chemotherapy

Many of the diseases of the peripheral nervous system may present similarly to muscle problems (myopathies), and so it is important to develop approaches for assessing sensory and motor disturbances in patients so that a physician may make an accurate diagnosis.

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Pertussis

Pertussis, also known as whooping cough, is a highly contagious disease. Worldwide, there are 30–50 million pertussis cases and about 300,000 deaths per year (World Health Organization data).

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Phenotype

The phenotype of an individual organism is either its total physical appearance and constitution or a specific manifestation of a trait, such as size, eye color, or behavior that varies between individuals.

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Physical Therapy

Physical therapy (or physiotherapy) is the provision of services to people to develop, maintain and restore maximum movement and functional ability throughout the life span. It includes the provision of services in circumstances where movement and function are threatened by the process of ageing or that of injury or disease.

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Physiological

Being in accord with or characteristic of the normal functioning of a living organism.

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Plateau

A period or state of little or no growth or decline.

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Polymyalgia Rheumatica (PMR)

Polymyalgia rheumatica (PMR) is an inflammatory disorder that causes widespread muscle aching and stiffness, primarily in your neck, shoulders, upper arms, thighs and hips.

Although some people develop these symptoms gradually, polymyalgia rheumatica can literally appear overnight. People with polymyalgia rheumatica may go to bed feeling fine, only to awaken with stiffness and pain the next morning.

Just what triggers polymyalgia rheumatica isn't known, but the cause may be a problem with the immune system, perhaps involving both genetic and environmental factors. Aging also appears to play a role.

Polymyalgia rheumatica usually goes away on its own in a year or two. But you don't have to endure polymyalgia rheumatica for months or years. Medications and self-care measures can improve your symptoms.

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Polymyositis

Polymyositis is one of a group of muscle diseases known as the inflammatory myopathies, which are characterized by chronic muscle inflammation accompanied by muscle weakness. Polymyositis affects skeletal muscles (those involved with making movement) on both sides of the body. It is rarely seen in persons under age 18; most cases are in adults between the ages of 31 and 60.

Progressive muscle weakness starts in the proximal muscles (muscles closest to the trunk of the body) which eventually leads to difficulties climbing stairs, rising from a seated position, lifting objects, or reaching overhead.

People with polymyositis may also experience arthritis, shortness of breath, difficulty swallowing and speaking, and heart arrhythmias. In some cases of polymyositis, distal muscles (muscles further away from the trunk of the body, such as those in the forearms and around the ankles and wrists) may be affected as the disease progresses.

Polymyositis may be associated with collagen-vascular or autoimmune diseases, such as lupus. Polymyositis may also be associated with infectious disorders, such as HIV-AIDS.

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Polypeptide

A peptide, such as a small protein, containing many molecules of amino acids, typically between 10 and 100.

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Polyphenols

Polyphenols are a group of chemical substances found in plants, characterized by the presence of more than one phenol group per molecule. Polyphenols are generally further subdivided into hydrolyzable tannins, which are gallic acid esters of glucose and other sugars; and phenylpropanoids, such as lignins, flavonoids, and condensed tannins.

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Post-Exertional Malaise

Malaise is a vague feeling of body discomfort or a general feeling of being unwell, much like you feel when you're coming down with a cold or the flu.

Post-exertional malaise is a period of intense exhaustion and other ME/CFS symptoms that lasts for more than 24 hours following physical exertion. This symptom is a hallmark of chronic fatigue syndrome (CFS or ME/CFS) and causes detectable differences in the blood that are being studied as a possible diagnostic marker.

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Postural Orthostatic Tachycardia Syndrome (POTS)

Postural orthostatic tachycardia syndrome is defined by excessive heart rate increments upon upright posture. A person with POTS will experience heart rates that increase 30 beats or more per minute upon standing and/or increase to 120 beats or more per minute upon standing (Grubb, 2000). These exaggerated heart rate increases usually occur within 10 minutes of rising.

While the hallmark of POTS is an excessive heart rate increment upon standing, patients often exhibit numerous symptoms of autonomic nervous system dysregulation, and research by the Mayo Clinic suggests POTS is a limited autonomic neuropathy (Thieben, Sandroni, Sletten, Benrud-Larson, Fealey, Vernino, Lennon, Shen & Low, 2007). Many POTS symptoms seem to be caused by an imbalance of the autonomic nervous system's control over blood flow. It is the autonomic nervous system (ANS) that regulates the needed adjustments in vascular tone, heart rate and blood pressure upon standing. Some of the messages coming from the autonomic nervous system tell the blood vessels to relax or tighten. In people with POTS, the system seems to be out of balance and blood is not going to the right place at the right time to do what the body needs (Fischer, 2007).

The autonomic nervous system is responsible for regulating a multitude of organs and functions throughout the body. Some of these functions include temperature, respiration, pupil dilation and constriction, salivation and the digestive tract. A patient experiencing ANS dysregulation may experience abnormalities in the many organs and functions the ANS regulates. For example, around one third to one half of POTS patients have digestive troubles (Fischer, 2007). The problem is that blood flow is not matching the need, so blood is not going to the right part of the intestinal system when it needs to. As a result, these people have trouble with nausea. For a smaller percentage of patients, the trouble is that there is too much blood in parts of the intestines. The body is attempting to digest food when there is no food to digest. This leads to cramping and colicky-like pains (Fischer, 2007).

POTS can be categorized as primary, meaning it is idiopathic and not associated with other diseases, or secondary, meaning it is associated with a known disease or disorder (Grubb, Kanjwal & Kosinski, 2006). Physicians believe there are distinct subtypes within both the primary and secondary forms, however the subtypes are still in the process of being identified, labeled and universally accepted. Regardless of type, POTS is not contagious.

People generally develop POTS after becoming sick with a virus, giving birth, or being exposed to great bodily stressors (i.e. surgery, trauma or chemotherapy). Some people have had POTS their entire lives. Teenagers sometimes develop the disorder during the years of rapid growth, and 75-80% of them can look forward to being asymptomatic when they reach adulthood (Grubb, Kanjwal & Kosinski, 2006).

The symptoms of POTS are life altering and debilitating at times. POTS patients use about three times more energy to stand than a healthy person (Grubb, 2002). It is as if these patients are running in place all the time. Activities such as housework, bathing, and even meals can exacerbate symptoms (Grubb, Kanjwal & Kosinski, 2006). Research shows that POTS patients' quality of life is similar to those with congestive heart failure and chronic obstructive pulmonary disease (Benrud-Larson, Dewar, Sandroni, Rummans, Haythornthwaite & Low, 2002) Twenty-five percent of people with POTS are disabled and unable to work (Goldstein, Robertson, Esler, Straus, & Eisenhofer, 2002). Most patients will have to make some lifestyle adjustments to cope with this disorder.

It was once estimated that nearly 500,000 Americans had POTS, which made standing up a challenge (Robertson, 1999). However, with research advances and growing physician education the number of people found to have POTS symptoms is steadily rising. It is now estimated that one out of every hundred teens has POTS (Fischer, 2007).

POTS patients tend to be between the ages of 15 and 50 (Grubb & McMann, 2001, p. 65). Women are 5 times more likely to develop POTS than men (Grubb & McMann, 2001, p. 65). POTS does run in some families. The onset can be sudden or gradual. The quantity and severity of symptoms varies from day to day.

There are treatments for POTS symptoms which can be tailored to each individual patient, especially if an underlying cause is discovered. Researchers are attempting to identify and treat the mechanisms and causes of POTS. Studies show that most patients will eventually be able to stand up with fewer symptoms (Low, 2000). Most people with POTS can look forward to experiencing improvement with proper treatment.

Source:

  1. Benrud-Larson, L. M., Dewar, M. S., Sandroni, P., Rummans, T. A., Haythornthwaite, J. A., & Low, P. A. (2002, June). Quality of life in patients with postural tachycardia syndrome. Mayo Clinic Proceedings, 77, 531-537.

  2. Brunner, L. S. & Suddarth, D. S. (2000). Assessment of cardiovascular function. In S. C. Smeltzer & B. G. Bare (Eds.), Brunner and Suddarth's textbook medical-surgical nursing (pp. 532-563). Philadelphia, PA: Lippincott Williams and Wilkins.

  3. Fischer, P. (2007). Postural orthostatic tachycardia syndrome. Mayo Clinic Podcast.

  4. Goldstein, D., Robertson, D., Esler, M., Straus, S., & Eisenhofer, G. (2002). Dysautonomias: clinical disorders of the autonomic nervous System. Ann Intern Med., 137, 753–763. Full Text

  5. Grubb, B. P. (2000, July). Orthostatic intolerance. National Dysautonomia Research Foundation Patient Conference. Minneapolis, Minnesota.

  6. Grubb, B. P. (2002, October). The heterogeneity of symptoms related to dysautonomia. Symposium conducted at the meeting of theNational Dysautonomia Research Foundation Northwest Ohio Support Group. Toledo, Ohio.

  7. Grubb B. P., Kanjwal, Y., & Kosinski, D. J. (2006). The postural tachycardia syndrome: A concise guide to diagnosis and management. J Cardiovasc Electrophysiol., 17, 108-112.

  8. Grubb, B. P., & McMann, M. C. (2001). The Fainting Phenomenon: Understanding why people faint and what can be done about it. New York: Futura Publishing Company.

  9. Low, P. A. (2000, July). Orthostatic intolerance. National Dysautonomia Research Foundation Patient Conference. Minneapolis, Minnesota.

  10. Robertson, D. (1999). The epidemic of orthostatic tachycardia and orthostatic intolerance. The American Journal of the Medical Sciences, 317, 75-77.

  11. Thieben, M. J., Sandroni, P., Sletten, D. N., Benrud-Larson, L. M.,Fealey, R. D., Vernino, S., Lennon, V. A., Shen, W. K., & Low, P. A., (2007). Postural orthostatic tachycardia syndrome: the Mayo Clinic experience. Mayo Clin. Proc. 82, (3), 308-313.

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Psychoneuroimmunology

Psychoneuroimmunology (PNI) investigates the relations between the psycho physiological and immunophysiological dimensions of living beings. PNI brings together researchers in a number of scientific and medical disciplines, including psychology, the neuroscience, immunology, physiology, pharmacology, psychiatry, behavioral medicine, infectious diseases, and rheumatology.

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Precipitate

To bring about especially abruptly.

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Post-Viral Fatigue Syndrome

Post-viral fatigue syndrome (PVFS) is a condition that presents a fatigue-like state resulting from a severe viral infection. The term is not widely used, but the state of prolonged or severe fatigue after illness is not uncommon. Some persons will experience fatigue of a few months to years following a severe infection or illness.

Post-viral syndromes may include: post-polio syndrome, late Lyme disease, and the extended fatigue and weakness common after mononucleosis or other severe viral infections.

Some researchers claim that post-viral fatigue syndrome is a biological state of weakness or damage to the immune system, and that it is common to many post-viral syndromes. It is hoped that immune system research, especially that connected to HIV, may lead to better understanding of, and treatments for, other post-viral syndromes.

PVFS was adopted as a new name for Myalgic Encephalomyelitis (ME) (known in the United States and elsewhere as chronic fatigue syndrome) in the United Kingdom in the nineteen-eighties, in an attempt to more accurately reflect the condition. However, the term was criticized for its failure to cover cases of CFS which appeared to result from exposure to toxins or allergens, and was not widely adopted. It appears in medical papers and journals from the period in reference to what is now called ME.

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Primary Sleep Disorders

Primary sleep disorders are those not caused by another mental disorder, a physical condition, or a substance. The two main primary sleep disorders are Dyssomnias and parasomnias.

Dyssomnias include primary insomnia, primary hypersomnia, narcolepsy, breathing related sleep disorder, circadian rhythm sleep disorder, and dyssomnia NOS.

Parasomnias include nightmare disorder, sleep terror disorder, sleepwalking disorder, and parasomnia NOS.

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Prohormone

A prohormone is a substance that is a precursor to a hormone, usually having minimal hormonal effect by itself. The term has been used in medical science since the middle of the 20th century. Examples of natural, human prohormones include proinsulin and pro-opiomelanocortin.

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Progressive

Moving forward, increasing in extent or severity.

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Psoriasis

Psoriasis is a chronic, autoimmune disease that appears on the skin. It occurs when the immune system sends out faulty signals that speed up the growth cycle of skin cells. Psoriasis is not contagious. It commonly causes red, scaly patches to appear on the skin, although some patients have no dermatological symptoms. The scaly patches commonly caused by psoriasis, called psoriatic plaques, are areas of inflammation and excessive skin production. Skin rapidly accumulates at these sites which gives it a silvery-white appearance. Plaques frequently occur on the skin of the elbows and knees, but can affect any area including the scalp, palms of hands and soles of feet, and genitals. In contrast to eczema, psoriasis is more likely to be found on the outer side of the joint.

The disorder is a chronic recurring condition that varies in severity from minor localized patches to complete body coverage. Fingernails and toenails are frequently affected (psoriatic nail dystrophy) and can be seen as an isolated symptom. Psoriasis can also cause inflammation of the joints, which is known as psoriatic arthritis. Ten to fifteen percent of people with psoriasis have psoriatic arthritis.

The cause of psoriasis is not fully understood, but it is believed to have a genetic component and local psoriatic changes can be triggered by an injury to the skin known as Koebner phenomenon. Various environmental factors have been suggested as aggravating to psoriasis including stress, withdrawal of systemic corticosteroid, excessive alcohol consumption, and smoking but few have shown statistical significance. There are many treatments available, but because of its chronic recurrent nature psoriasis is a challenge to treat.

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Psoriatic Arthritis

Psoriatic arthritis is a chronic disease characterized by inflammation of the skin (psoriasis) and joints (arthritis). Psoriasis is a common skin condition affecting 2% of the Caucasian population in the United States. It features patchy, raised, red areas of skin inflammation with scaling. Psoriasis often affects the tips of the elbows and knees, the scalp, the navel, and around the genital areas or anus. Approximately 10% of patients who have psoriasis also develop an associated inflammation of their joints. Patients who have inflammatory arthritis and psoriasis are diagnosed as having psoriatic arthritis.

The onset of psoriatic arthritis generally occurs in the fourth and fifth decades of life. Males and females are affected equally. The skin disease (psoriasis) and the joint disease (arthritis) often appear separately. In fact, the skin disease precedes the arthritis in nearly 80% of patients. However, the arthritis may precede the psoriasis in up to 15% of patients. In some patients, the diagnosis of psoriatic arthritis can be difficult if the arthritis precedes psoriasis by many years. In fact, some patients have had arthritis for over 20 years before psoriasis eventually appears! Conversely, patients can have psoriasis for over 20 years prior to the development of arthritis, leading to the ultimate diagnosis of psoriatic arthritis.

Psoriatic arthritis is a systemic rheumatic disease that also can cause inflammation in body tissues away from the joints other than the skin, such as in the eyes, heart, lungs, and kidneys. Psoriatic arthritis shares many features with several other arthritic conditions, such as ankylosing spondylitis, reactive arthritis (formerly known as Reiter's syndrome), and arthritis associated with Crohn's disease and ulcerative colitis. All of these conditions can cause inflammation in the spine and other joints, and the eyes, skin, mouth, and various organs. In view of their similarities and tendency to cause inflammation of the spine, these conditions are collectively referred to as "spondyloarthropathies."

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Raynaud's Phenomenon

Raynaud's phenomenon (RAY-noz), in medicine, is a vasospastic disorder causing discoloration of the fingers, toes, and occasionally other extremities, named for French physician Maurice Raynaud (1834 - 1881). The cause of the phenomenon is unknown, but emotional stress and cold are classically triggers, and the discoloration follows a characteristic pattern in time: white, blue and red. It comprises both Raynaud's disease (primary Raynaud's), where the phenomenon is idiopathic, and Raynaud's syndrome (secondary Raynaud's), where it is secondary to something else.

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Reflex Sympathetic Dystrophy

Reflex Sympathetic Dystrophy Syndrome (RSDS/RSD) is also known as Chronic Regional Pain Syndrome (CRPS). RSD is classified as a chronic neurological syndrome that shares some of the symptoms of fibromyalgia including chronic pain. Many individuals who are diagnosed with RSD disease suffer from other conditions such as fibromyalgia and chronic fatigue syndrome, which can make the diagnosis of RSD symptoms difficult.

There are two types of Chronic Regional Pain Syndrome: Type I and Type II. Type II CRPS is known as Reflex Sympathetic Dystrophy Syndrome.

RSD is caused by a disturbance of the sympathetic nervous system, the network of nerves located along the spinal cord which controls bodily functions such as the opening and closing of blood vessels and sweat glands, and is also linked to emotions.

RSDS primarily affects the hands and feet, creating changes in the blood flow, which leads to weakened bones. If RSDS is left untreated, the disease can spread to other parts of the body.

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Rehabilitation

The process of restoration of skills by a person who has had an illness or injury so as to regain maximum self-sufficiency and function in a normal or as near normal manner as possible. For example, rehabilitation after a stroke may help the patient walk again and speak clearly again.

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Relapse

To fall back into illness after convalescence or apparent recovery.

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Relaxation Techniques

Relaxation techniques are used by people who wish to relax, for a wide variety of reasons. Since the 1960s, research has indicated strong correlations between stress levels and physical and emotional health.

Meditation was among the first relaxation techniques shown to have a measurable effect on stress reduction. In the 1970s, self-help books teaching relaxation techniques began to appear on bestsellers lists.

In 1975, The Relaxation Response by Harvard Medical School professor Herbert Benson, MD and Miriam Z. Klipper was published. Their book has been credited with popularizing meditation in the United States.

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Remission

Remission is the state of absence of disease activity in patients with known chronic illness.

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Restless Leg Syndrome (RLS)

RLS causes unpleasant sensations in the lower limbs, so much so that the limbs have to be moved in order to reduce the pain. RLS occurs mostly at night, between the hours of 10:00 pm and 4:00 am, although it can occur throughout the day in severe cases. It is thought that somewhere between 20% and 40% of FM sufferers also have RLS.

The sensations are unusual and unlike other common sensations, and those with RLS have a hard time describing them. People use words such as: uncomfortable, antsy, electrical, creeping, painful, itching, pins and needles, pulling, creepy-crawly, ants inside the legs, and many others. The sensation and the urge can occur in any body part; the most cited location is legs, followed by arms. Some people have little or no sensation, yet still have a strong urge to move.

Any type of inactivity involving sitting or lying - reading a book, a plane ride, watching TV or a movie, taking a nap - can trigger the sensations and urge to move. This depends on several factors: the severity of the person's RLS, the degree of restfulness, the duration of the inactivity, etc.

About 10 percent of adults in North America and Europe may experience RLS symptoms, according to the National Sleep Foundation, which reports that "lower prevalence has been found in India, Japan and Singapore," indicating that ethnic factors, including diet, may play a role in the prevalence of this syndrome.

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Resuscitate

To revive from apparent death or from unconsciousness.

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Retroviruses

A retrovirus is a type of virus that inserts its DNA into your cell's genetic makeup. Preliminary research has linked one retrovirus, called XMRV, to chronic fatigue syndrome. Only three retroviruses have been identified in humans. The best-known retrovirus is HIV, which can cause AIDS.

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Reye's Syndrome

Reye's syndrome is a potentially fatal disease that causes numerous detrimental effects to many organs, especially the brain and liver.

The precise mechanism by which Reye's syndrome occurs remains unknown. This serious illness is referred to as a "syndrome" because the clinical features that physicians use to make diagnoses are generally not very specific for a single disorder. However, the major form of Reye’s syndrome reported in the United States is characteristically preceded by a viral-like flu illness or chickenpox.

Many studies have demonstrated a strong association between aspirin taken for these viral illnesses and the development of Reye’s syndrome. Some studies indicate that a significant percentage of cases, particularly in very young children, are later re-categorized as other disorders or conditions -- as high as 25% in the UK and 50% in Australia. These re-categorized disorders, unlike the characteristic Reye’s syndrome, are not strongly linked to exposure to aspirin.

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Rheumatoid Arthritis

Rheumatoid arthritis (RA) is traditionally considered a chronic, inflammatory autoimmune disorder that causes the immune system to attack the joints. It is a disabling and painful inflammatory condition, which can lead to substantial loss of mobility due to pain and joint destruction. RA is a systemic disease, often affecting extra-articular tissues throughout the body including the skin, blood vessels, heart, lungs, and muscles. About 60% of RA patients are unable to work 10 years after the onset of their disease.

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RNase L

RNase L is an enzyme found in every cell in the body which is activated within a particular cell when it comes under attack from viruses, and to a lesser extent bacteria and some toxins. The job of RNase L is to take care of the threat from invading viruses by destroying their RNA or by signaling an already infected cell to die, taking the virus with it.

It has been found in numerous studies that CFS/ME patients have fragmented RNase L and the RNase L system as a whole is dysfunctional. As a result the patient has compromised defenses against viral infection. The RNase L abnormalities are seen as the closest thing to a bio-marker for CFS/ME currently available as the findings are so consistent.

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Rule-Out

A term used much in medicine, meaning to eliminate or exclude something from consideration. Example - The ACB (albumin cobalt binding) test helps rule out a heart attack in the differential diagnosis of severe chest pain.

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Sarcoidosis

Sarcoidosis is an immune system disorder characterized by non-necrotising granulomas (small inflammatory nodules). Virtually any organ can be affected; however, granulomas most often appear in the lungs or the lymph nodes.

Symptoms can occasionally appear suddenly but usually appear gradually. When viewing X-rays of the lungs, sarcoidosis can have the appearance of tuberculosis or lymphoma.

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Scapula

The scapula, or shoulder blade, is the bone that connects the humerus (arm bone) with the clavicle (collar bone). The scapula forms the posterior part of the shoulder girdle. In humans, it is a flat bone, roughly triangular in shape.

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Scleroderma

Scleroderma is a chronic systemic autoimmune disease (primarily of the skin) characterized by fibrosis (or hardening), vascular alterations, and autoantibodies. There are two major forms:

Limited systemic sclerosis/scleroderma involves cutaneous manifestations that mainly affect the hands, arms and face. Previously called CREST syndrome in reference to the following complications: Calcinosis, Raynaud's phenomenon, Esophageal dysfunction, Sclerodactyly, and Telangiectasias. Additionally, pulmonary arterial hypertension may occur in up to one third of patients and is the most serious complication for this form of scleroderma.

Diffuse systemic sclerosis/scleroderma is rapidly progressing and affects a large area of the skin and one or more internal organs, frequently the kidneys, esophagus, heart and lungs. This form of scleroderma can be quite disabling. There are no treatments for scleroderma itself, but individual organ system complications are treated.

Other forms of scleroderma include systemic sine scleroderma, which lacks skin changes, but has systemic manifestations, and two localized forms which affect the skin, but not the internal organs: morphea, and linear scleroderma.

The prognosis is generally good for limited cutaneous scleroderma patients who escape pulmonary complications, but is worse for those with the diffuse cutaneous disease, particularly in older age, and for males. Death occurs most often from pulmonary, heart and kidney complications. In diffuse cutaneous disease, five-year survival is 70%, 10-year survival is 55%.

The cause is unknown. Scleroderma runs in families, but the genes have not been identified. It affects the small blood vessels (arterioles) in all organs. First, the endothelial cells of the arteriole die off, along with smooth muscle cells, by a process of apoptosis. They are replaced by collagen and other fibrous material. Inflammatory cells, particularly CD4+ helper T cells, infiltrate the arteriole, and cause further damage. Many of the inflammatory and destructive protein signals have been identified, and they are potential targets for drugs that could interrupt the process.

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Seasonal Affective Disorder

Seasonal affective disorder (SAD) is a mood disorder that causes symptoms of depression and fatigue. A type of major depression, seasonal affective disorder is linked to the changing seasons. It typically onsets during the fall months and continues throughout the winter season. Symptoms only go away with the change of seasons during the springtime. Symptoms of seasonal affective disorder can range from mild to severe and, in some cases, the illness can become debilitating.

Seasonal affective disorder is also linked with a chemical imbalance that results from the decrease in daylight hours. Melatonin, a brain chemical that plays a role in determining mood, is produced in greater quantities when it is dark outside. This means that more melatonin is produced during the fall and winter. An increase in this hormone can cause symptoms of depression.

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Semispinalis Capitis Muscle

The Semispinalis capitis is situated at the upper and back part of the neck, beneath the Splenius, and medial to the Longissimus cervicis and capitis.

It arises by a series of tendons from the tips of the transverse processes of the upper six or seven thoracic and the seventh cervical vertebrae, and from the articular processes of the three cervical above this.

The tendons, uniting, form a broad muscle, which passes upward, and is inserted between the superior and inferior nuchal lines of the occipital bone.

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Serotonin

Serotonin is a neurotransmitter, derived from tryptophan, that is involved in sleep (along with melatonin), depression, memory and other neurological processes. People with fibromyalgia may have abnormally low serotonin levels, while studies are split as to whether levels are abnormally high or abnormally low in chronic fatigue syndrome sufferers.

Serotonin levels can be raised by medications called SSRIs or SNRIs. It also may be raised by certain dietary supplements. Learn more about low serotonin, its symptoms, and how to increase available amounts: Low Serotonin in Fibromyalgia & Chronic Fatigue Syndrome

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Serotonin Syndrome

Serotonin syndrome is a potentially life threatening adverse drug reaction that may occur following therapeutic drug use, inadvertent interactions between drugs, overdose of particular drugs, or the recreational use of certain drugs. Serotonin syndrome is not an idiosyncratic drug reaction; it is a predictable consequence of excess serotonergic activity at central nervous system (CNS) and peripheral serotonin receptors. For this reason, some experts strongly prefer the terms serotonin toxicity or serotonin toxidrome because these more accurately reflect the fact that it is a form of poisoning. It may also be called serotonin storm, hyperserotonemia, or serotonergic syndrome.

The excess serotonin activity produces a spectrum of specific symptoms including cognitive, autonomic, and somatic effects. The symptoms may range from barely perceptible to fatal. Numerous drugs and drug combinations have been reported to produce serotonin syndrome. Diagnosis of serotonin syndrome includes observing the symptoms produced and a thorough investigation of the patient's history. The syndrome has a characteristic picture but can be mistaken for other illnesses in some patients, particularly those with neuroleptic malignant syndrome. No laboratory tests can currently confirm the diagnosis.

Treatment consists of discontinuing medications which may contribute and in moderate to severe cases administering a serotonin antagonist. An important adjunct treatment includes controlling agitation with benzodiazepine sedation.

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Sign

Any objective evidence of disease. Gross blood in the stool is a sign of disease. It can be recognized by the patient, doctor, nurse, or others. In contrast, a symptom is, by its nature, subjective. Abdominal pain is a symptom. It is something only the patient can know.

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Sinusitis

Sinusitis is an inflammation of the paranasal sinuses, which may or may not be as a result of infection, from bacterial, fungal, viral, allergic or autoimmune issues. Newer classifications of sinusitis refer to it as rhinosinusitis, taking into account the thought that inflammation of the sinuses cannot occur without some inflammation of the nose as well (rhinitis).

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Sjögren's Syndrome

Sjögren's syndrome is an autoimmune disorder in which immune cells attack and destroy the exocrine glands that produce tears and saliva. It is named after Swedish ophthalmologist Henrik Sjögren (1899-1986), who first described it. Sjögren's syndrome is also associated with rheumatic disorders such as rheumatoid arthritis, and it is rheumatoid factor positive in 90 percent of cases.

The hallmark symptoms of the disorder are dry mouth and dry eyes (part of what are known as sicca symptoms). In addition, Sjögren's syndrome may cause skin, nose, and vaginal dryness, and may affect other organs of the body, including the kidneys, blood vessels, lungs, liver, pancreas, and brain. Nine out of ten Sjögren's patients are women and the average age of onset is late 40s, although Sjögren's occurs in all age groups in both women and men. It is estimated to strike as many as 4 million people in the United States alone making it the second most common autoimmune rheumatic disease.

More Information About Sjögren's Syndrome

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Skeletal Muscles

Skeletal muscle is a type of striated muscle, attached to the skeleton. Skeletal muscles are used to create movement, by applying force to bones and joints; via contraction. They generally contract voluntarily (via nerve stimulation), although they can contract involuntarily through reflexes.

Skeletal muscles usually have one end (the "origin") attached to a relatively stationary bone, (such as the scapula) and the other end (the "insertion") is attached across a joint to another bone (such as the humerus).

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Sleep Apnea

Sleep Apnea is a sleep disorder characterized by pauses in breathing during sleep. These episodes, called apneas (literally meaning, "without breath"), last long enough so one or more breaths are missed, and occur repeatedly throughout sleep. Sleep apnea is diagnosed with an overnight sleep test called polysomnogram.

Clinically significant levels of sleep apnea are defined as 5 events of any type or greater per hour of sleep time (from the polysomnogram). There are two distinct forms of sleep apnea: Central and Obstructive. Breathing is interrupted by the lack of effort in Central Sleep Apnea. In Obstructive Sleep Apnea, breathing is interrupted by a physical block to airflow despite effort. In Mixed Sleep Apnea, there is a transition from central to obstructive features during the events themselves.

Regardless of type, the individual with sleep apnea is rarely aware of having difficulty breathing, even upon awakening. Sleep apnea is recognized as a problem by others witnessing the individual during episodes or is suspected because of its effects on the body. Symptoms may be present for years, even decades without identification, during which time the sufferer may become conditioned to the daytime sleepiness and fatigue associated with significant levels of sleep disturbance. The definitive diagnosis of sleep apnea is made by polysomnography. 80% of people with FM suffer from sleep apnea.

Obstructive sleep apnea (OSA) is not only much more frequent than Central Sleep Apnea, it is a common condition in many parts of the world. If studied carefully in a sleep lab by polysomnography, approximately 1 in 5 American adults has at least mild OSA. Since the muscle tone of the body ordinarily relaxes during sleep, and since, at the level of the throat, the human airway is composed of walls of soft tissue, which can collapse, it is easy to understand why breathing can be obstructed during sleep - particularly in the obese. Although many individuals experience episodes of obstructive sleep apnea at some point in life, a much smaller percentage of people are afflicted with chronic severe obstructive sleep apnea.

Normal sleep/wakefulness in adults has been given 6 distinct stages, numbered 1-4 and including REM sleep (Stage 5) and Wake. The deeper stages (3-4) are required for the physically restorative effects of sleep and in pre-adolescents are the focus of release for human growth hormone. Stages 2 and REM, which combined are 70% of an average person's total sleep time, are more associated with mental recovery and maintenance. During REM sleep in particular, muscle tone of the throat and neck, as well as the vast majority of all skeletal muscles, is almost completely weakened, allowing the tongue and soft palate/oropharynx to relax, and in the case of sleep apnea, to impede the flow of air to a degree ranging from light snoring to complete collapse. In the cases where airflow is reduced to a degree where blood oxygen levels fall, or the physical exertion to breathe is too great, neurological mechanisms trigger a sudden interruption of sleep, called a neurological arousal. These arousals may or may not result in complete awakening, but can have a significant negative effect on the restorative quality of sleep. In significant cases of obstructive sleep apnea, one consequence is sleep deprivation due to the repetitive disruption and recovery of sleep activity. This sleep interruption in stages 3 and 4 (also collectively called Slow-Wave Sleep), can interfere with normal growth patterns, healing, and immune response, especially in children and young adults.

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Sleep Medication

Sedative-hypnotics are central nervous system (CNS) depressants, a category of drugs that slow normal brain function. There are various kinds of CNS depressants, most of which act on the brain by affecting the neurotransmitter gamma-aminobutyric acid (GABA). Neurotransmitters are brain chemicals that conduct communication between brain cells. GABA works by decreasing brain activity. Although the different types of CNS depressants each work in their own way, ultimately it is through their ability to increase GABA activity that they produce a relaxing effect that is beneficial to those suffering from anxiety or sleep disorders.

Among the medications that are commonly prescribed for these purposes are the following:

The more relaxing benzodiazepines, such as triazolam (Halcion®) and estazolam (ProSom®) can be prescribed for short-term treatment of sleep disorders.

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SNRI's

Serotonin–norepinephrine reuptake inhibitors (SNRIs) are a class of antidepressant drugs used in the treatment of major depression and other mood disorders. They are also used to treat anxiety disorders, obsessive-compulsive disorder (OCD), attention deficit hyperactivity disorder (ADHD), chronic neuropathic pain, fibromyalgia (FM), and for the relief of menopausal symptoms.

SNRI's act upon and increase the levels of two neurotransmitters in the brain that are known to play an important part in mood, these being serotonin and norepinephrine. This can be contrasted with the more widely-used selective serotonin reuptake inhibitors (SSRI's) which act more selectively on serotonin.

Because the SNRI's and SSRI's both act similarly to elevate serotonin levels, they subsequently share many of the same side effects, though to varying degrees. The most common include:

  • loss of appetite, weight, and sleep
  • drowsiness
  • dizziness
  • fatigue
  • headache
  • mydriasis
  • nausea/vomiting
  • sexual dysfunction
  • urinary retention

There are two common sexual side effects: diminished interest in sex (libido) and difficulty reaching climax (anorgasmia), which are usually somewhat milder with the SNRI's in comparison to the SSRI's. Nonetheless, sexual side effects account for lack of compliance with both SSRI's and SNRI's.

It should be noted that while tricyclic antidepressants (TCA's) also produce similar sexual side effects as SNRI's, discontinuation of TCAs is more often due to the other side effects (like cardiovascular effects).

Elevation of norepinephrine levels can sometimes cause anxiety, mildly elevated pulse, and elevated blood pressure. People at risk for hypertension and heart disease should have their blood pressure monitored.

Examples of SNRIs are:

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SPECT

A single-photon emission computerized tomography (SPECT) scan lets your doctor analyze the function of your internal organs. A SPECT scan is a type of nuclear imaging test, which means it uses a radioactive substance and a special camera to create pictures of your organs.

While imaging tests such as X-rays can show what the structures inside your body look like, a SPECT scan produces 3-D images that show how your organs work. For instance, a SPECT scan can show how blood flows to your heart or what areas of your brain are more active or less active.

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Splenius Capitis Muscle

The splenius capitis arises from the lower half of the ligamentum nuchæ, from the spinous process of the seventh cervical vertebra, and from the spinous processes of the upper three or four thoracic vertebrae.

The fibers of the muscle are directed upward and lateralward and are inserted, under cover of the Sternocleidomastoideus, into the mastoid process of the temporal bone, and into the rough surface on the occipital bone just below the lateral third of the superior nuchal line.

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Sporadically

Appearing in scattered or isolated instances, as a disease.

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SSRI's

Selective serotonin re uptake inhibitors or SSRI's increase the extra cellular (outside the cell) level of serotonin in the brain. The brain passes messages between nerve cells via a phenomenon called a synapse or gap between the cells. An SSRI keeps serotonin in that gap longer and stimulates the receptor cell to better receive the message. This increased presence of serotonin is what is believed to alleviate depression and anxiety.

To list anxiety / depression drugs in this class involves both generic and brand names now widely recognized. Fluoxetine, for instance, is best known by the brand name Prozac whereas paroxetine is better known as Paxil. Citalopram is sold as Celexa and sertraline as Zoloft.

Although effective and popular, these are powerful medications. Normally the body requires one to four weeks to adjust to a regimen of SSRI's during which time some side effect symptoms will be felt. These include nausea, drowsiness, headache, weight gain or loss, increased or decreased appetite, and sexual dysfunction. During this period, there may even be an increase of anxiety and depression.

Users should never go "cold turkey" off SSRI's but should slowly decrease their dosage. Although not recognized as addictive, some SSRI users who have discontinued the medication report withdrawal-like symptoms and even nerve damage when the drug is removed too suddenly.

List of SSRI's

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Sternocleidomastoid Muscle

The sternocleidomastoid muscles are anterior muscles in the neck that act to flex and rotate the head.

It is given the name sternocleidomastoid because it originates with the sternum (sterno-) and clavicle (cleido-), and articulates with the mastoid process of the temporal bone of the skull. It is also called the sternomastoid muscle.

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Stress

Forces from the outside world impinging on the individual. Stress is a normal part of life that can help us learn and grow. Conversely, stress can cause us significant problems.

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Substance P

A small peptide released upon stimulation in the nervous system and involved in regulation of the pain threshold. Increased levels of substance P increase the sensitivity of nerves to pain or heighten awareness of pain. People with fibromyalgia can have elevated levels of substance P.

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Supraspinatus Muscle

The supraspinatus is a relatively small muscle of the upper limb that takes its name from its origin from the supraspinous fossa superior to the spine of the scapula. It is one of the four rotator cuff muscles and also abducts the arm at the shoulder. The spine of the scapula separates the supraspinatus muscle from the infraspinatus muscle, which originates below the spine.

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Supine Position

The supine position is a position of the body; lying down with the face up, as opposed to the prone position, which is face down. In layman's terms, this is simply lying on your back staring upwards.

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Symptom

Any subjective evidence of disease. Anxiety, lower back pain, and fatigue are all symptoms. They are sensations only the patient can perceive. In contrast, a sign is objective evidence of disease. A bloody nose is a sign. It is evident to the patient, doctor, nurse and other observers.

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Syndrome

A syndrome is a set of signs and symptoms that are known to occur together and suggest a particular abnormality, but without a known cause. It does not imply that the condition is less severe than a disease; it means that it's not as well understood.

Fibromyalgia and chronic fatigue syndrome both fit this definition because researchers haven't yet discovered what causes the numerous symptoms and changes in the body.

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Systemic

Affecting the entire body. A systemic disease such as diabetes can affect the whole body. Systemic chemotherapy employs drugs that travel through the bloodstream and reach and affect cells all over the body.

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Tachycardia

Tachycardia refers to a rapid beating of the heart. By convention the term refers to heart rates greater than 100 beats per minute in the adult patient. Tachycardia may be a perfectly normal physiological response to stress. However, depending on the mechanism of the tachycardia and the health status of the patient, tachycardia may be harmful, and require medical treatment. In extreme cases, tachycardia can be life threatening.

Tachycardia can be harmful in two ways. First, when the heart beats too rapidly, it may perform inefficiently. Second, the faster the heart beats, the more oxygen and nutrients the heart requires. This may leave patients feeling out of breath. This can be especially problematic for patients suffering from ischemic heart disease.

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Tai Chi

Tai Chi is a gentle art of health and well-being for people of all ages and health conditions. Many thousands of people are enjoying the health benefits of Taoist Tai Chi practice in approximately 510 locations in 25 countries around the world.

Taoist Tai Chi was introduced to western society by Master Moy Lin-shin in 1970 and is designed fundamentally to promote and restore health. This purpose distinguishes Taoist Tai Chi from other forms of Tai Chi. The slow, graceful movements of Taoist Tai Chi increase strength and flexibility and improve balance and circulation. The Taoist style of Tai Chi emphasizes greater stretching and turning in each of the movements in order to gain these and other benefits more effectively.

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T Cells

A type of white blood cell that's critical to the immune response. T cells attack virus-infected, foreign or cancerous cells. T cells also can activate or deactivate immune cells.

Research suggests that people with chronic fatigue syndrome may have reduced T cell response to certain infectious agents, supporting the theory that many symptoms of the condition may be caused by a chronic immune response possibly triggered by an abnormal response to common infectious agents.

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Temporal Arteritis

Temporal arteritis, also called giant cell arteritis is an inflammatory disease of blood vessels (most commonly large and medium arteries of the head). It is therefore a form of vasculitis. The name comes from the most frequently involved vessel (temporal artery which branches from the external carotid artery of the neck). The alternative name (giant cell arteritis) reflects the type of inflammatory cell that is involved (as seen on biopsy).

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Temporomandibular Joint Syndrome

Also known as T.M.J. this disorder affects the functioning of the temporomandibular joint (TMJ), more commonly referred to as the jawbone. TMJ also attacks the muscles and cartilage throughout the face, head, and neck. TMJ dysfunction can cause a variety of problems, ranging from headaches to a locked jaw, so it is important to get any symptoms of TMJ properly diagnosed.

More than 40% of the population will experience some type of jaw problem in their life. But TMJ is more than just a little jaw problem – it is a serious joint disorder that can cause extreme pain and discomfort. When coupled with FM symptoms, TMJ can be debilitating. It is thought that more than 75% of people with FM also suffer from some type of TMJ. About 25% of these people suffer chronically from TMJ. Like FM, most sufferers of TMJ are female and between the ages of 20 and 50.


What Is The Temporomandibular Joint?

The temporomandibular joint (TMJ) is the area directly in front of the ear on either side of the head where the upper jaw (maxilla) and lower jaw (mandible) meet. Within the TMJ, there are moving parts that allow the upper jaw to close on the lower jaw. This joint is a typical sliding "ball and socket" that has a disc sandwiched between it. The TMJ is used throughout the day to move the jaw, especially in biting and chewing, talking, and yawning. It is one of the most frequently used joints of the body.

The temporomandibular joints are complex and are composed of muscles, tendons, and bones. Each component contributes to the smooth operation of the TMJ. When the muscles are relaxed and balanced and both jaw joints open and close comfortably, we are able to talk, chew, or yawn without pain.

We can locate the TMJ by putting a finger on the triangular structure in front of the ear. The finger is moved just slightly forward and pressed firmly while opening the jaw. The motion felt is from the TMJ. We can also feel the joint motion if we put a little finger against the inside front part of the ear canal. These maneuvers can cause considerable discomfort to a person who is experiencing TMJ difficulty, and doctors use them for making the diagnosis.


What Are TMJ Disorders, And How Are TMJ Disorders Caused?

TMJ disorders are a group of complex problems of the jaw joint. TMJ disorders are also sometimes referred to as myofacial pain dysfunction and Costen's syndrome. Because muscles and joints work together, a problem with either one can lead to stiffness, headaches, ear pain, bite problems (malocclusion), clicking sounds, or locked jaws. The following are behaviors or conditions that can lead to TMJ disorders.

  • Teeth grinding and teeth clenching (bruxism) increase the wear on the cartilage lining of the TMJ. Those who grind or clench their teeth may be unaware of this behavior unless they are told by someone observing this pattern while sleeping or by a dental professional noticing telltale signs of wear and tear on the teeth. Many patients awaken in the morning with jaw or ear pain.

  • Habitual gum chewing or fingernail biting

  • Dental problems and misalignment of the teeth (malocclusion). Patients may complain that it is difficult to find a comfortable bite or that the way their teeth fit together has changed. Chewing on only one side of the jaw can lead to or be a result of TMJ problems.

  • Trauma to the jaws: Previous fractures in the jaw or facial bones can lead to TMJ disorders.

  • Stress frequently leads to unreleased nervous energy. It is very common for people under stress to release this nervous energy by either consciously or unconsciously grinding and clenching their teeth.

  • Occupational tasks such as holding the telephone between the head and shoulder may contribute to TMJ disorders.

What Are Common TMJ Symptoms?

TMJ pain disorders usually occur because of unbalanced activity, spasm, or overuse of the jaw muscles. Symptoms tend to be chronic, and treatment is aimed at eliminating the precipitating factors. Many symptoms may not appear related to the TMJ itself. The following are common symptoms.


  • Headache:
    Approximately 80% of patients with a TMJ disorder complain of headache, and 40% report facial pain. Pain is often made worse while opening and closing the jaw. Exposure to cold weather or air-conditioned air may increase muscle contraction and facial pain.

  • Ear pain:
    About 50% of patients with a TMJ disorder notice ear pain and do not have signs of ear infection. The ear pain is usually described as being in front of or below the ear. Often, patients are treated multiple times for a presumed ear infection, which can often be distinguished from TMJ disorder by an associated hearing loss or ear drainage (which would be expected if there really was an ear infection). Because ear pain occurs so commonly, ear specialists are frequently called on to make the diagnosis of a TMJ disorder.

  • Sounds:
    Grinding, crunching, or popping sounds, medically termed crepitus, are common for patients with a TMJ disorder. These sounds may or may not be accompanied by increased pain.

  • Dizziness:
    Of patients with a TMJ disorder, 40% report a vague sense of dizziness or imbalance (usually not a spinning type vertigo). The cause of this type of dizziness is not well understood.

  • Fullness of the ear:
    About 33% of patients with a TMJ disorder describe muffled, clogged, or full ears. They may notice ear fullness and pain during airplane takeoffs and landings. These symptoms are usually caused by eustachian-tube dysfunction, the structure responsible for the regulation of pressure in the middle ear. It is thought that patients with TMJ disorders have hyperactivity (spasms) of the muscles responsible for regulating the opening and closing of the eustachian tube.

  • Ringing in the ear (tinnitus):
    For unknown reasons, 33% of patients with a TMJ disorder experience noise or ringing in the ears (tinnitus). Of those patients, half will have resolution of their tinnitus after successful treatment of their TMJ disorder.

How Are Patients Evaluated And Diagnosed?

A complete dental and medical evaluation is often necessary and recommended to evaluate patients with suspected TMJ disorders. One or more of the following diagnostic clues or procedures may be used to establish the diagnosis. Damaged jaw joints are suspected when there are popping, clicking, and grating sounds associated with movement of the jaw. Chewing may become painful, and the jaw may lock or not open widely.

The teeth may be worn smooth, as well as show a loss of the normal bumps and ridges on the tooth surface. Ear symptoms are very common. Infection of the ear, sinuses, and teeth can be discovered by medical and dental examination. Dental X-rays and computerized tomography (CT) scanning help to define the bony detail of the joint, while magnetic resonance imaging (MRI) is used to analyze soft tissues.

What Is The Treatment for TMJ Disorders?

The mainstay of treatment for acute TMJ pain is heat and ice, soft diet, and anti-inflammatory medications.

  1. Jaw rest:
    It can be beneficial to keep the teeth apart as much as possible. It is also important to recognize when tooth grinding is occurring and devise methods to cease this activity. Patients are advised to avoid chewing gum or eating hard, chewy, or crunchy foods such as raw vegetables, candy, or nuts. Foods that require opening the mouth widely, such as a big hamburger, are also not recommended.

  2. Heat and ice therapy:
    These assist in reducing muscle tension and spasm. However, immediately after an injury to the TMJ, treatment with cold applications is best. Cold packs can be helpful for relieving pain.

  3. Medications:
    Anti-inflammatory medications such as aspirin, ibuprofen (Advil and others), naproxen (Aleve and others), or steroids can help control inflammation. Muscle relaxants, such as diazepam (Valium), aid in decreasing muscle spasms. In certain situations, local injection of cortisone preparations (methylprednisolone [Depo-Medrol], triamcinolone [Kenalog], Celestone) into the TMJ may be helpful.

  4. Physical therapy:
    Passively opening and closing the jaw, massage, and electrical stimulation help to decrease pain and increase the range of motion and strength of the joint.

  5. Stress management:
    Stress support groups, psychological counseling, and medications can also assist in reducing muscle tension. Biofeedback helps people recognize times of increased muscle activity and spasm and provides methods to help control them.

  6. Occlusal therapy:
    A custom-made acrylic appliance which fits over the teeth is commonly prescribed for night but may be required throughout the day. It acts to balance the bite and reduce or eliminate teeth grinding or clenching (bruxism).

  7. Correction of bite abnormalities:
    Corrective dental therapy, such as orthodontics, may be required to correct an abnormal bite. Dental restorations assist in creating a more stable bite. Adjustments of bridges or crowns act to ensure proper alignment of the teeth.

  8. Surgery:
    Surgery is indicated in those situations in which medical therapy has failed. It is done as a last resort. TMJ arthroscopy, ligament tightening, joint restructuring, and joint replacement are considered in the most severe cases of joint damage or deterioration.

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Tendon

A tendon (or sinew) is a tough band of fibrous connective tissue that connects muscle to bone or muscle to muscle and is designed to withstand tension. Tendons are similar to ligaments except that ligaments join one bone to another. Tendons and muscles work together and can only exert a pulling force.

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Testosterone

Testosterone is a steroid hormone from the androgen group. Testosterone is primarily secreted in the testes of males and the ovaries of females although small amounts are secreted by the adrenal glands.

It is the principal male sex hormone and an anabolic steroid. In both males and females, it plays key roles in health and well-being. Examples include enhanced libido, energy, immune function, and protection against osteoporosis.

On average, the adult male body produces about twenty to thirty times the amount of testosterone that an adult female's body does.

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Thalamus

The thalamus is a pair and symmetric part of the brain.

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Therapeutic

Relating to therapeutics, that part of medicine concerned specifically with the treatment of disease. The therapeutic dose of a drug is the amount needed to treat a disease.

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Therapy

Is the attempted remediation of a health problem, usually following a diagnosis.

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Thorax

The thorax is a division of an animal's body that lies between the head and the abdomen. In mammals, the thorax is the region of the body formed by the sternum, the thoracic vertebrae and the ribs. It extends from the neck to the diaphragm, not including the upper limbs. The heart and the lungs reside in the thoracic cavity, as well as many blood vessels. The inner organs are protected by the rib cage and the sternum.

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Thrombosis

Thrombosis is the formation of a clot or thrombus inside a blood vessel, obstructing the flow of blood through the circulatory system.

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Thyroid

The thyroid one of the larger endocrine glands in the body. This gland is found in the neck just below the Adam's apple. The thyroid controls how quickly the body burns energy, makes proteins and how sensitive the body should be to other hormones.

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Thyroid Disease

Thyroid disease occurs when the thyroid gland doesn't supply the proper amount of hormones needed by the body. If the thyroid is overactive, it releases too much thyroid hormone into the bloodstream, resulting in hyperthyroidism. Hyperthyroidism causes the body to use up energy more quickly than it should, and chemical activity (like metabolism) in the cells speeds up.

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Tinnitus

Tinnitus is the perception of sound in the human ear in the absence of corresponding external sound(s). Tinnitus can be perceived in one or both ears or in the head. It is usually described as a ringing noise, but in some patients it takes the form of a high pitched whining, buzzing, hissing, humming, or whistling sound, or as ticking, clicking, roaring, "crickets" or "locusts", tunes, songs, or beeping. It has also been described as a "whooshing" sound, as of wind or waves.

Tinnitus is not itself a disease but a symptom resulting from a range of underlying causes, including ear infections, foreign objects or wax in the ear, and injury from loud noises. Tinnitus is also a side-effect of some oral medications, such as aspirin, and may also result from an abnormally low level of serotonin.

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Tomography

Tomography is imaging by sections or sectioning. A device used in tomography is called a tomograph, while the image produced is a tomogram.

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Transverse Processes

The transverse processes of a vertebra, two in number, project one at either side from the point where the lamina joins the pedicle, between the superior and inferior articular processes. They serve for the attachment of muscles and ligaments.

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Trapezius Muscle

the trapezius is a large superficial muscle on a person's back. Because the fibers run in different directions, it has a variety of actions, including:

  • scapular elevation(shrugging up or lifting the shoulders)
  • scapular adduction (drawing the shoulder blades)
  • scapular depression (pulling the shoulder blades down)

Different fibers control different actions:

  • The superior (upper) fibers elevate the scapula.
  • the middle fibers retract it.
  • The inferior (lower) fibers depress it.

When the superior and inferior fibers act together they superiorly (upwardly) rotate the scapula.

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Tricyclic Antidepressants

Tricyclic antidepressants first began to be used in the 1950s. Although the specific action of these drugs (Amitriptyline, Clomipramine, and Impindole among others) is not clearly understood, they are thought to increase the presence of norepinephrine and serotonin in the nerve cells of the brain.

This older class of drugs although relatively effective carried a wide range of unwanted side effects including dry mouth, blurred vision, constipation, weight gain, dizziness, high blood pressure, muscle twitches, and sexual dysfunction. In some individuals they actually increase anxiety.

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Tuberculosis

Tuberculosis (abbreviated as TB for Tubercle Bacillus) is a common and deadly infectious disease that is caused by mycobacteria, primarily Mycobacterium tuberculosis.

Tuberculosis most commonly affects the lungs (as pulmonary TB) but can also affect the central nervous system, the lymphatic system, the circulatory system, the genitourinary system, bones, joints and even the skin.

Other mycobacteria such as Mycobacterium bovis, Mycobacterium africanum and Mycobacterium microti can also cause tuberculosis, but these species do not usually infect healthy adults.

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Urea

An organic compound of carbon, nitrogen, oxygen and hydrogen, with the formula CON2H4 or (NH2)2CO.

Urea is also known as carbamide, especially in the recommended International Non-proprietary Names (rINN) in use in Europe. For example, the medicinal compound hydroxyurea (old British Approved Name) is now hydroxycarbamide. Other names include carbamide resin, isourea, carbonyl diamide, and carbonyldiamine.

It was the first organic compound to be artificially synthesized from inorganic starting materials, thus dispelling the concept of Vitalism.

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Uveitis

Uveitis specifically refers to inflammation of the middle layer of the eye, termed the "uvea" but in common usage may refer to any inflammatory process involving the interior of the eye.

Uveitis is estimated to be responsible for approximately 10% of the blindness in the United States. Uveitis requires an urgent referral and thorough examination by an Optometrist or ophthalmologist along with urgent treatment to control the inflammation.

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Vasopressin Metabolism

A polypeptide hormone that is secreted together with oxytocin by the posterior lobe of the pituitary gland, is also obtained synthetically, and increases blood pressure and exerts an antidiuretic effect.

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Vertigo

Vertigo sometimes called a head rush, is a major symptom of a balance disorder. It is the sensation of spinning while the body is stationary with respect to the earth or surroundings. With the eyes shut, there will be a sensation that the body is in movement, called subjective vertigo; if the eyes are open, the surroundings will appear to move past the field of vision, called objective vertigo.

The effects may be slight. It can cause nausea and vomiting or, if severe, may give rise to difficulty with standing and walking. Vertigo is usually associated with a problem in the inner ear balance mechanisms (vestibular system), in the brain, or with the nerve connections between these two organs. The most common cause is benign paroxysmal positional vertigo, or BPPV. Vertigo can be a symptom of an underlying harmless cause, such as in BPPV or it can suggest more serious problems. These include drug toxicities, strokes or tumors (though these are much less common than BPPV). Vertigo can also be brought on suddenly through various actions or incidents, such as skull fractures, sudden changes of blood pressure, or as a symptom of motion sickness while sailing, riding amusement rides or in a vehicle.

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Virus

A microorganism smaller than a bacteria, which cannot grow or reproduce apart from a living cell. A virus invades living cells and uses their chemical machinery to keep itself alive and to replicate itself. It may reproduce with fidelity or with errors (mutations)- this ability to mutate is responsible for the ability of some viruses to change slightly in each infected person, making treatment more difficult.

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XAND

XAND stands for X-Associated Neuroimmune Disorder. The Whittemore Institution, where the connection between chronic fatigue syndrome and the XMRV virus was first made, has proposed this new disease entity -- XAND -- that would include chronic fatigue syndrome and other conditions related to XMRV-virus infection.

Research connecting XMRV to chronic fatigue syndrome is in the preliminary stages and will need to be replicated and expanded before the findings or the proposed name become accepted by the medical community.

On September 22, 2011, Science published online a nine-lab study widely seen as the final blow to the theory, championed by Mikovits and colleagues in an October 2009 Science paper, that a recently detected mouse retrovirus might play a causal role in chronic fatigue syndrome (CFS). A letter in the same issue of Science from one of the contributing labs to the 2009 report revealed that a contamination had marred its contribution-PCR detection and sequencing of the mouse virus, dubbed XMRV. Mikovits and colleagues defended the validity of the rest of the study, known as Lombardi et al., which detected the virus by several other methods, so Science issued a rare partial retraction of the original paper. Mikovits was fired from Whittemore Peterson Institute on September 29, 2011.

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Xenotropic

"Xeno" means foreign, and "tropic" refers to growth. The term xenotropic is used to describe viruses that don't replicate or cause problems in their original host, but become a problem when introduced to a different host.

Preliminary research had linked a xenotropic retrovirus called XMRV to chronic fatigue syndrome. It was later found that the material had been tainted.

On September 22, 2011, Science published online a nine-lab study widely seen as the final blow to the theory, championed by Mikovits and colleagues in an October 2009 Science paper, that a recently detected mouse retrovirus might play a causal role in chronic fatigue syndrome (CFS). A letter in the same issue of Science from one of the contributing labs to the 2009 report revealed that a contamination had marred its contribution-PCR detection and sequencing of the mouse virus, dubbed XMRV. Mikovits and colleagues defended the validity of the rest of the study, known as Lombardi et al., which detected the virus by several other methods, so Science issued a rare partial retraction of the original paper. Mikovits was fired from Whittemore Peterson Institute on September 29, 2011.

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XMRV

XMRV is a retrovirus that some preliminary research has linked to chronic fatigue syndrome. Researchers are also looking into possible links between XMRV and prostate cancer, as well as other conditions.

XMRV stands for:

  • Xenotropic
  • Murine leukemia virus
  • Related
  • Virus

On September 22, 2011, Science published online a nine-lab study widely seen as the final blow to the theory, championed by Mikovits and colleagues in an October 2009 Science paper, that a recently detected mouse retrovirus might play a causal role in chronic fatigue syndrome (CFS). A letter in the same issue of Science from one of the contributing labs to the 2009 report revealed that a contamination had marred its contribution-PCR detection and sequencing of the mouse virus, dubbed XMRV. Mikovits and colleagues defended the validity of the rest of the study, known as Lombardi et al., which detected the virus by several other methods, so Science issued a rare partial retraction of the original paper. Mikovits was fired from Whittemore Peterson Institute on September 29, 2011.

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Yeast Infections

Yeast infections are caused by candida albicans, a yeast-like plant that is produced by the body under normal conditions.

However, candida albicans can lead to a yeast infection when there is an excessive growth of candida. Yeast infections are a fungal overgrowth commonly found in the vagina, which often lead to vaginal pain, irritation and swelling.

Chronic yeast infections occur when the growth of yeast spreads through the body, leading to a variety of symptoms.

Many health experts believe that there is a relationship between fibromyalgia and vaginal yeast infections, and more specifically, candida albicans. But what is the nature of the connection between fibromyalgia and candida? Do FMS sufferers have more yeast infections than non-FMS sufferers?

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Yoga

Yoga refers to traditional physical and mental disciplines originating in India. The word is associated with meditative practices in Hinduism, Buddhism and Jainism. Within Hinduism, it also refers to one of the six orthodox schools of Hindu philosophy, and to the goal toward which that school directs its practices. In Jainism yoga is the sum total of all activities - mental, verbal and physical.

Major branches of yoga in Hindu philosophy include Raja Yoga, Karma Yoga, Jnana Yoga, Bhakti Yoga, and Hatha Yoga. Raja Yoga, compiled in the Yoga Sutras of Patanjali, and known simply as yoga in the context of Hindu philosophy, is part of the Samkhya tradition. Many other Hindu texts discuss aspects of yoga, including Upanishads, the Bhagavad Gita, the Hatha Yoga Pradipika, the Shiva Samhita and various Tantras.

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