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Sample records for fatigue syndrome cfs

  1. Chronic Fatigue Syndrome (CFS): Symptoms

    Science.gov (United States)

    ... CDC.gov . Chronic Fatigue Syndrome (CFS) Share Compartir Symptoms On this Page Primary Symptoms Other Symptoms What's ... a doctor distinguish CFS from other illnesses. Primary Symptoms As the name chronic fatigue syndrome suggests , fatigue ...

  2. Chronic Fatigue Syndrome (CFS): Diagnosis

    Science.gov (United States)

    ... multiple sclerosis, fibromyalgia, primary sleep disorders, and major depressive disorder. Medications can also cause side effects that mimic the symptoms of CFS. Because CFS can resemble many other ...

  3. Migraine headaches in Chronic Fatigue Syndrome (CFS: Comparison of two prospective cross-sectional studies

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    Merck Samantha J

    2011-03-01

    Full Text Available Abstract Background Headaches are more frequent in Chronic Fatigue Syndrome (CFS than healthy control (HC subjects. The 2004 International Headache Society (IHS criteria were used to define CFS headache phenotypes. Methods Subjects in Cohort 1 (HC = 368; CFS = 203 completed questionnaires about many diverse symptoms by giving nominal (yes/no answers. Cohort 2 (HC = 21; CFS = 67 had more focused evaluations. They scored symptom severities on 0 to 4 anchored ordinal scales, and had structured headache evaluations. All subjects had history and physical examinations; assessments for exclusion criteria; questionnaires about CFS related symptoms (0 to 4 scale, Multidimensional Fatigue Inventory (MFI and Medical Outcome Survey Short Form 36 (MOS SF-36. Results Demographics, trends for the number of diffuse "functional" symptoms present, and severity of CFS case designation criteria symptoms were equivalent between CFS subjects in Cohorts 1 and 2. HC had significantly fewer symptoms, lower MFI and higher SF-36 domain scores than CFS in both cohorts. Migraine headaches were found in 84%, and tension-type headaches in 81% of Cohort 2 CFS. This compared to 5% and 45%, respectively, in HC. The CFS group had migraine without aura (60%; MO; CFS+MO, with aura (24%; CFS+MA, tension headaches only (12%, or no headaches (4%. Co-morbid tension and migraine headaches were found in 67% of CFS. CFS+MA had higher severity scores than CFS+MO for the sum of scores for poor memory, dizziness, balance, and numbness ("Neuro-construct", p = 0.002 and perceived heart rhythm disturbances, palpitations and noncardiac chest pain ("Cardio-construct"; p = 0.045, t-tests after Bonferroni corrections. CFS+MO subjects had lower pressure-induced pain thresholds (2.36 kg [1.95-2.78; 95% C.I.] n = 40 and a higher prevalence of fibromyalgia (47%; 1990 criteria compared to HC (5.23 kg [3.95-6.52] n = 20; and 0%, respectively. Sumatriptan was beneficial for 13 out of 14 newly diagnosed

  4. Ideal versus reality: physicians perspectives on patients with chronic fatigue syndrome (CFS) and fibromyalgia.

    Science.gov (United States)

    Asbring, Pia; Närvänen, Anna-Liisa

    2003-08-01

    Encountering patients with chronic fatigue syndrome (CFS) or fibromyalgia can cause dilemmas for physicians due to the uncertainty inherent in these illnesses. The aim of this study was to investigate: (1). How physicians in a Swedish sample describe and categorize patients with CFS and fibromyalgia; (2). What the character of CFS and fibromyalgia, with regard to diagnosing, treatment and medical knowledge/aetiology, mean to the physicians in encounters with patients; and (3). Which strategies physicians describe that they use in the encounter with these patients. Semi-structured interviews were carried out with 26 physicians, specialists in various fields who all had some experience of either CFS or fibromyalgia. The results suggest that there is a discrepancy between the ideal role of the physician and reality in the everyday work in interaction with these patients. This may lead to the professional role being questioned. Different strategies are developed to handle the encounters with these patients. The results also illuminate the physician's interpretations of patients in moralising terms. Conditions given the status of illness were regarded, for example, as less serious by the physicians than those with disease status. Scepticism was expressed regarding especially CFS, but also fibromyalgia. Moreover, it is shown how the patients are characterised by the physicians as ambitious, active, illness focused, demanding and medicalising. The patient groups in question do not always gain full access to the sick-role, in part as a consequence of the conditions not being defined as diseases.

  5. Maintenance of Chronic Fatigue Syndrome (CFS in Young CFS Patients Is Associated with the 5-HTTLPR and SNP rs25531 A > G Genotype.

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    Benedicte Meyer

    Full Text Available Earlier studies have shown that genetic variability in the SLC6A4 gene encoding the serotonin transporter (5-HTT may be important for the re-uptake of serotonin (5-HT in the central nervous system. In the present study we investigated how the 5-HTT genotype i.e. the short (S versus long (L 5-HTTLPR allele and the SNP rs25531 A > G affect the physical and psychosocial functioning in patients with chronic fatigue syndrome (CFS. All 120 patients were recruited from The Department of Paediatrics at Oslo University Hospital, Norway, a national referral center for young CFS patients (12-18 years. Main outcomes were number of steps per day obtained by an accelerometer and disability scored by the Functional Disability Inventory (FDI. Patients with the 5-HTT SS or SLG genotype had a significantly lower number of steps per day than patients with the 5-HTT LALG, SLA or LALA genotype. Patients with the 5-HTT SS or SLG genotype also had a significantly higher FDI score than patients with the 5-HTT LALG, SLA or LALA genotype. Thus, CFS patients with the 5-HTT SS or SLG genotype had worse 30 weeks outcome than CFS patients with the 5-HTT LALG, SLA or LALA genotype. The present study suggests that the 5-HTT genotype may be a factor that contributes to maintenance of CFS.

  6. Changes in Gut and Plasma Microbiome following Exercise Challenge in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS.

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    Sanjay K Shukla

    Full Text Available Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS is a disease characterized by intense and debilitating fatigue not due to physical activity that has persisted for at least 6 months, post-exertional malaise, unrefreshing sleep, and accompanied by a number of secondary symptoms, including sore throat, memory and concentration impairment, headache, and muscle/joint pain. In patients with post-exertional malaise, significant worsening of symptoms occurs following physical exertion and exercise challenge serves as a useful method for identifying biomarkers for exertion intolerance. Evidence suggests that intestinal dysbiosis and systemic responses to gut microorganisms may play a role in the symptomology of ME/CFS. As such, we hypothesized that post-exertion worsening of ME/CFS symptoms could be due to increased bacterial translocation from the intestine into the systemic circulation. To test this hypothesis, we collected symptom reports and blood and stool samples from ten clinically characterized ME/CFS patients and ten matched healthy controls before and 15 minutes, 48 hours, and 72 hours after a maximal exercise challenge. Microbiomes of blood and stool samples were examined. Stool sample microbiomes differed between ME/CFS patients and healthy controls in the abundance of several major bacterial phyla. Following maximal exercise challenge, there was an increase in relative abundance of 6 of the 9 major bacterial phyla/genera in ME/CFS patients from baseline to 72 hours post-exercise compared to only 2 of the 9 phyla/genera in controls (p = 0.005. There was also a significant difference in clearance of specific bacterial phyla from blood following exercise with high levels of bacterial sequences maintained at 72 hours post-exercise in ME/CFS patients versus clearance in the controls. These results provide evidence for a systemic effect of an altered gut microbiome in ME/CFS patients compared to controls. Upon exercise challenge, there

  7. Chronic fatigue syndrome (CFS) or myalgic encephalomyelitis (ME) is different in children compared to in adults : a study of UK and Dutch clinical cohorts

    NARCIS (Netherlands)

    Collin, Simon M.; Nuevo, Roberto; van de Putte, Elise M.; Nijhof, Sanne L.; Crawley, Esther

    2015-01-01

    Objective To investigate differences between young children, adolescents and adults with chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME). Study design Comparison of clinical cohorts from 8 paediatric and 27 adult CFS/ME services in the UK and a paediatric randomised controlled trial from

  8. The Health-Related Quality of Life for Patients with Myalgic Encephalomyelitis / Chronic Fatigue Syndrome (ME/CFS.

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    Michael Falk Hvidberg

    Full Text Available Myalgic encephalomyelitis (ME/chronic fatigue syndrome (CFS is a common, severe condition affecting 0.2 to 0.4 per cent of the population. Even so, no recent international EQ-5D based health-related quality of life (HRQoL estimates exist for ME/CFS patients. The main purpose of this study was to estimate HRQoL scores using the EQ-5D-3L with Danish time trade-off tariffs. Secondary, the aims were to explore whether the results are not influenced by other conditions using regression, to compare the estimates to 20 other conditions and finally to present ME/CFS patient characteristics for use in clinical practice.All members of the Danish ME/CFS Patient Association in 2013 (n=319 were asked to fill out a questionnaire including the EQ-5D-3L. From these, 105 ME/CFS patients were identified and gave valid responses. Unadjusted EQ-5D-3L means were calculated and compared to the population mean as well as to the mean of 20 other conditions. Furthermore, adjusted estimates were calculated using ordinary least squares (OLS regression, adjusting for gender, age, education, and co-morbidity of 18 self-reported conditions. Data from the North Denmark Health Profile 2010 was used as population reference in the regression analysis (n=23,392.The unadjusted EQ-5D-3L mean of ME/CFS was 0.47 [0.41-0.53] compared to a population mean of 0.85 [0.84-0.86]. The OLS regression estimated a disutility of -0.29 [-0.21;-0.34] for ME/CFS patients in this study. The characteristics of ME/CFS patients are different from the population with respect to gender, relationship, employment etc.The EQ-5D-3L-based HRQoL of ME/CFS is significantly lower than the population mean and the lowest of all the compared conditions. The adjusted analysis confirms that poor HRQoL of ME/CFS is distinctly different from and not a proxy of the other included conditions. However, further studies are needed to exclude the possible selection bias of the current study.

  9. Chronic Fatigue Syndrome

    Science.gov (United States)

    Chronic fatigue syndrome (CFS) is a disorder that causes extreme fatigue. This fatigue is not the kind of tired feeling that ... activities. The main symptom of CFS is severe fatigue that lasts for 6 months or more. You ...

  10. Chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME in adults: a qualitative study of perspectives from professional practice

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    Campion Peter D

    2010-11-01

    Full Text Available Abstract Background Chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME can cause profound and prolonged illness and disability, and poses significant problems of uncertainty for healthcare professionals in its diagnosis and management. The aim of this qualitative study was to explore the nature of professional 'best practice' in working with people with CFS/ME. Methods The views and experiences of health care practitioners (HCPs were sought, who had been judged by people with CFS/ME themselves to have been particularly helpful and effective. Qualitative semi-structured interviews following a topic guide were carried out with six health care practitioners. Interviews were audio-recorded, transcribed and subject to thematic analysis. Results Five main themes were developed: 1 Diagnosis; 2 Professional perspectives on living with CFS/ME; 3 Interventions for treatment and management; 4 Professional values and support for people with CFS/ME and their families; 5 Health professional roles and working practices. Key findings related to: the diagnostic process, especially the degree of uncertainty which may be shared by primary care physicians and patients alike; the continued denial in some quarters of the existence of CFS/ME as a condition; the variability, complexity, and serious impact of the condition on life and living; the onus on the person with CFS/ME to manage their condition, supported by HCPs; the wealth of often conflicting and confusing information on the condition and options for treatment; and the vital role of extended listening and trustful relationships with patients. Conclusions While professional frustrations were clearly expressed about the variability of services both in primary and specialist care and continuing equivocal attitudes to CFS/ME as a condition, there were also strong positive messages for people with CFS/ME where the right services are in place. Many of the findings from these practitioners seen by their

  11. A Brief Historic Overview of Clinical Disorders Associated with Tryptophan: The Relevance to Chronic Fatigue Syndrome (CFS) and Fibromyalgia (FM).

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    Blankfield, Adele

    2012-01-01

    Last century there was a short burst of interest in the tryptophan related disorders of pellagra and related abnormalities that are usually presented in infancy.1,2 Nutritional physiologists recognized that a severe human dietary deficiency of either tryptophan or the B group vitamins could result in central nervous system (CNS) sequelae such as ataxia, cognitive dysfunction and dysphoria, accompanied by skin hyperpigmentation.3,4 The current paper will focus on the emerging role of tryptophan in chronic fatigue syndrome (CFS) and fibromyalgia (FM).

  12. Children's experiences of chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME): a systematic review and meta-ethnography of qualitative studies

    Science.gov (United States)

    Parslow, Roxanne M; Harris, Sarah; Broughton, Jessica; Alattas, Adla; Crawley, Esther; Haywood, Kirstie; Shaw, Alison

    2017-01-01

    Objective To synthesis the qualitative studies of children's experiences of chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME). Design Systematic review and meta-ethnography. Background CFS/ME is an important disabling illness, with uncertain cause and prognosis. As a result, children with CFS/ME can find themselves living with greater uncertainty and stigma, exacerbating the impact of the condition. There is a growing body of qualitative research in CFS/ME, yet there has been no attempt to systematically synthesis the studies involving children. Methods Studies exploring the experiences of children diagnosed with CFS/ME, published or unpublished, using qualitative methods were eligible. MEDLINE, EMBASE, PsycINFO and CINAHL databases were searched as well as grey literature, reference lists and contacting authors. Quality assessment was done independently using the Critical Appraisal Skills Programme (CASP) checklist. Studies were synthesised using techniques of meta-ethnography. Results Ten studies involving 82 children with CFS/ME aged 8–18 were included. Our synthesis describes four third-order constructs within children's experiences: (1) disruption and loss: physical, social and the self; (2) barriers to coping: suspension in uncertainty, problems with diagnosis and disbelief; (3) facilitators to coping: reducing uncertainty, credible illness narratives, diagnosis and supportive relationships and (4) hope, personal growth and recovery. CFS/ME introduces profound biographical disruption through its effects on children's ability to socialise, perform school and therefore how they see their future. Unfamiliarity of the condition, problems with diagnosis and felt stigma prevent children from forming a new illness identity. Children adopt coping strategies such as building credible explanations for their illness. Conclusions Physical, social, emotional and self-dimensions of life should be included when treating and measuring outcomes from healthcare in

  13. Prevalence of myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS in three regions of England: a repeated cross-sectional study in primary care

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    Fayyaz Shagufta

    2011-07-01

    Full Text Available Abstract Background Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS or chronic fatigue syndrome (CFS has been used to name a range of chronic conditions characterized by extreme fatigue and other disabling symptoms. Attempts to estimate the burden of disease have been limited by selection bias, and by lack of diagnostic biomarkers and of agreed reproducible case definitions. We estimated the prevalence and incidence of ME/CFS in three regions in England, and discussed the implications of frequency statistics and the use of different case definitions for health and social care planning and for research. Methods We compared the clinical presentation, prevalence and incidence of ME/CFS based on a sample of 143,000 individuals aged 18 to 64 years, covered by primary care services in three regions of England. Case ascertainment involved: 1 electronic search for chronic fatigue cases; 2 direct questioning of general practitioners (GPs on cases not previously identified by the search; and 3 clinical review of identified cases according to CDC-1994, Canadian and Epidemiological Case (ECD Definitions. This enabled the identification of cases with high validity. Results The estimated minimum prevalence rate of ME/CFS was 0.2% for cases meeting any of the study case definitions, 0.19% for the CDC-1994 definition, 0.11% for the Canadian definition and 0.03% for the ECD. The overall estimated minimal yearly incidence was 0.015%. The highest rates were found in London and the lowest in East Yorkshire. All but one of the cases conforming to the Canadian criteria also met the CDC-1994 criteria, however presented higher prevalence and severity of symptoms. Conclusions ME/CFS is not uncommon in England and represents a significant burden to patients and society. The number of people with chronic fatigue who do not meet specific criteria for ME/CFS is higher still. Both groups have high levels of need for service provision, including health and social

  14. Azithromycin in Chronic Fatigue Syndrome (CFS, an analysis of clinical data

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    Scholte Hans R

    2006-08-01

    Full Text Available Abstract Background CFS is a clinical state with defined symptoms, but undefined cause. The patients may show a chronic state of immune activation and treatment with an antibiotic in this subgroup has been suggested. Methods In a retrospective study, the response of CFS patients to azithromycin, an antibiotic and immunomodulating drug, has been scored from the patients records and compared with clinical and laboratory data. Azithromycin was not the first choice therapy, but offered when the effect of counseling and L-carnitine was considered insufficient by the patient and the clinician. Results Of the 99 patients investigated, 58 reported a decrease in the symptoms by the use of azithromycin. These responding patients had lower levels of plasma acetylcarnitine. Conclusion The efficacy of azithromycin in the responsive patients could be explained by the modulating effect on a chronic primed state of the immune cells of the brain, or the activated peripheral immune system. Their lower acetylcarnitine levels may reflect a decreased antioxidant defense and/or an increased consumption of acetylcarnitine caused by oxidative stress.

  15. What stops children with a chronic illness accessing health care: a mixed methods study in children with Chronic Fatigue Syndrome/Myalgic Encephalomyelitis (CFS/ME

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    Webb Carly M

    2011-11-01

    Full Text Available Abstract Background Paediatric Chronic Fatigue Syndrome/Myalgic Encephalomyelitis (CFS/ME is relatively common and disabling with a mean time out of school of more than one academic year. NICE guidelines recommend referral to specialist services immediately if severely affected, within 3 months if moderately affected and within 6 months if mildly affected. However, the median time-to-assessment by a specialist service in the UK is 18 months. This study used a mixed-methods approach to examine factors associated with time taken to access specialist services. Methods Time-to-assessment was analysed as a continuous "survival-time" variable in Cox regression models using data from self-completed assessment forms for children attending a regional specialist CFS/ME service between January 2006 and December 2009. Semi-structured interviews about barriers experienced in accessing healthcare for their child were conducted with nine parents of children aged Results 405 children were assessed between 2006 and 2009 and information on school attendance was available on 388. Only 1/125 with severe CFS/ME and 49/263 (19% with mild to moderate CFS/ME were seen within NICE recommended timeframe. Increased fatigue was associated with shorter time to assessment (HR = 1.15; 95% CI 1.03, 1.29 per unit increase in Chalder fatigue score; P = 0.01. Time-to-assessment was not associated with disability, mood, age or gender. Parents described difficulties accessing specialist services because of their own as well as their GP's and Paediatrician's lack of knowledge. They experienced negative attitudes and beliefs towards the child's condition when they consulted GPs, Paediatricians and Child Psychiatrists. Parents struggled to communicate an invisible illness that their child and not themselves were experiencing. Conclusions GPs, Child Psychiatrists and Paediatricians need more knowledge about CFS/ME and the appropriate referral pathways to ensure timeliness in referral

  16. Children's experiences of chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME): a systematic review and meta-ethnography of qualitative studies.

    Science.gov (United States)

    Parslow, Roxanne M; Harris, Sarah; Broughton, Jessica; Alattas, Adla; Crawley, Esther; Haywood, Kirstie; Shaw, Alison

    2017-01-13

    To synthesis the qualitative studies of children's experiences of chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME). Systematic review and meta-ethnography. CFS/ME is an important disabling illness, with uncertain cause and prognosis. As a result, children with CFS/ME can find themselves living with greater uncertainty and stigma, exacerbating the impact of the condition. There is a growing body of qualitative research in CFS/ME, yet there has been no attempt to systematically synthesis the studies involving children. Studies exploring the experiences of children diagnosed with CFS/ME, published or unpublished, using qualitative methods were eligible. MEDLINE, EMBASE, PsycINFO and CINAHL databases were searched as well as grey literature, reference lists and contacting authors. Quality assessment was done independently using the Critical Appraisal Skills Programme (CASP) checklist. Studies were synthesised using techniques of meta-ethnography. Ten studies involving 82 children with CFS/ME aged 8-18 were included. Our synthesis describes four third-order constructs within children's experiences: (1) disruption and loss: physical, social and the self; (2) barriers to coping: suspension in uncertainty, problems with diagnosis and disbelief; (3) facilitators to coping: reducing uncertainty, credible illness narratives, diagnosis and supportive relationships and (4) hope, personal growth and recovery. CFS/ME introduces profound biographical disruption through its effects on children's ability to socialise, perform school and therefore how they see their future. Unfamiliarity of the condition, problems with diagnosis and felt stigma prevent children from forming a new illness identity. Children adopt coping strategies such as building credible explanations for their illness. Physical, social, emotional and self-dimensions of life should be included when treating and measuring outcomes from healthcare in paediatric CFS/ME. There is a need for greater recognition

  17. Developing resources to support the diagnosis and management of Chronic Fatigue Syndrome/Myalgic Encephalitis (CFS/ME in primary care: a qualitative study

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    Hannon Kerin

    2012-09-01

    Full Text Available Abstract Background NICE guidelines emphasise the need for a confident, early diagnosis of Chronic Fatigue Syndrome/ Myalgic Encephalitis (CFS/ME in Primary Care with management tailored to the needs of the patient. Research suggests that GPs are reluctant to make the diagnosis and resources for management are currently inadequate. This study aimed to develop resources for practitioners and patients to support the diagnosis and management of CFS/ME in primary care. Methods Semi structured interviews were conducted with patients, carers, GPs, practice nurses and CFS/ME specialists in North West England. All interviews were audio recorded, transcribed and analysed qualitatively using open explorative thematic coding. Two patient involvement groups were consulted at each stage of the development of resources to ensure that the resources reflect everyday issues faced by people living with CFS/ME. Results Patients and carers stressed the importance of recognising CFS/ME as a legitimate condition, and the need to be believed by health care professionals. GPs and practice nurses stated that they do not always have the knowledge or skills to diagnose and manage the condition. They expressed a preference for an online training package. For patients, information on getting the most out of a consultation and the role of carers was thought to be important. Patients did not want to be overloaded with information at diagnosis, and suggested information should be given in steps. A DVD was suggested, to enable information sharing with carers and family, and also for those whose symptoms act as a barrier to reading. Conclusion Rather than use a top-down approach to the development of training for health care practitioners and information for patients and carers, we have used data from key stakeholders to develop a patient DVD, patient leaflets to guide symptom management and a modular e-learning resource which should equip GPs to diagnose and manage CFS

  18. Chronic fatigue syndrome (CFS) associated with Staphylococcus spp. bacteremia, responsive to potassium arsenite 0.5% in a veterinary surgeon and his coworking wife, handling with CFS animal cases.

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    Tarello, W

    2001-10-01

    Chronic fatigue syndrome (CFS) in human patients remain a controversial and perplexing condition with emerging zoonotic aspects. Recent advances in human medicine seem to indicate a bacterial etiology and the condition has already been described in horses, dogs, cats and birds of prey in association with micrococci-like organisms in the blood. To evaluate the possibility of a chronic bacteremia, a veterinary surgeon (the author) and his coworking wife, both diagnosed with CFS and meeting the CDC working case definition, were submitted to rapid blood cultures and fresh blood smears investigations. Blood cultures proved Staph-positive and micrococci-like organisms in the blood were repeatedly observed in the 3-year period preceding the arsenical therapy, during which several medicaments, including antibiotics, proved unsuccessful. Following treatment with a low dosage arsenical drug (potassium arsenite 0.5%, im., 1 ml/12 h, for 10 days) both patients experienced complete remission. At the post-treatment control made 1 month later, micrococci had disappeared from the blood, and the CD4/CD8 ratio was raising.

  19. Comparing specialist medical care with specialist medical care plus the Lightning Process® for chronic fatigue syndrome or myalgic encephalomyelitis (CFS/ME): study protocol for a randomised controlled trial (SMILE Trial)

    OpenAIRE

    Crawley, Esther; Mills, Nicola; Hollingworth, Will; Deans, Zuzana; Sterne, Jonathan A; Donovan, Jenny L; Beasant, Lucy; Montgomery, Alan

    2013-01-01

    Background Chronic fatigue syndrome or myalgic encephalomyelitis (CFS/ME) is a relatively common and potentially serious condition with a limited evidence base for treatment. Specialist treatment for paediatric CFS/ME uses interventions recommended by National Institute for Health and Clinical Excellence (NICE) including cognitive behavioural therapy, graded exercise therapy and activity management. The Lightning Process® (LP) is a trademarked intervention derived from osteopathy, life-coachi...

  20. The Health-Related Quality of Life for Patients with Myalgic Encephalomyelitis / Chronic Fatigue Syndrome (ME/CFS)

    DEFF Research Database (Denmark)

    Falk Hvidberg, Michael; Brinth, Louise Schouborg; Olesen, Anne V

    2015-01-01

    of this study was to estimate HRQoL scores using the EQ-5D-3L with Danish time trade-off tariffs. Secondary, the aims were to explore whether the results are not influenced by other conditions using regression, to compare the estimates to 20 other conditions and finally to present ME/CFS patient characteristics...... and compared to the population mean as well as to the mean of 20 other conditions. Furthermore, adjusted estimates were calculated using ordinary least squares (OLS) regression, adjusting for gender, age, education, and co-morbidity of 18 self-reported conditions. Data from the North Denmark Health Profile...

  1. Chronic Fatigue Syndrome (CFS): Causes

    Science.gov (United States)

    ... patients and in persons with related disorders like fibromyalgia. Cortisol suppresses inflammation and cellular immune activation, and ... 1994 Case Definition Causes Who's at Risk? Symptoms Diagnosis Patient Examination Process Step 1 Step 2 Step ...

  2. Chronic Fatigue Syndrome in Gulf War Veterans

    Science.gov (United States)

    ... Enter ZIP code here Enter ZIP code here Chronic Fatigue Syndrome in Gulf War Veterans Gulf War ... and be at least 10 percent disabling. About Chronic Fatigue Syndrome CFS is an unexplained, severe and ...

  3. Neuroaetiology of chronic fatigue syndrome : An overview

    NARCIS (Netherlands)

    Sanders, Patricia; Korf, Jakob

    2008-01-01

    Chronic fatigue syndrome (CFS) is now recognized as a medial disorder. In contrast to recent related reports, the present review focuses primarily on aetiological aspects of CFS. Four major hypotheses are reviewed. (1) Although CFS is often associated with viral infection, the presence of viruses ha

  4. Memory for Fatigue in Chronic Fatigue Syndrome: Relationships to Fatigue Variability, Catastrophizing, and Negative Affect

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    Sohl, Stephanie J.; Friedberg, Fred

    2008-01-01

    Fatigue in chronic fatigue syndrome (CFS) is usually assessed with retrospective measures rather than real-time momentary symptom assessments. In this study, the authors hypothesized that in participants with CFS, discrepancies between recalled and momentary fatigue would be related to catastrophizing, anxiety, and depression and to variability of momentary fatigue. They also expected that catastrophizing, anxiety, and depression would be associated with momentary fatigue. The authors asked 53 adults with CFS to carry electronic diaries for 3 weeks and record their experiences of momentary fatigue. The authors assessed participants' fatigue recall with weekly ratings and administered questionnaires for catastrophizing, depression, and anxiety. Recall discrepancy was significantly related to the variability of momentary fatigue. In addition, catastrophizing, depression, and momentary fatigue were all significantly related to recall discrepancy. Catastrophizing, depression, anxiety, and momentary negative affect were all significantly associated with momentary fatigue. The findings suggest that momentary fatigue in patients with CFS is related to modifiable psychological factors. PMID:18400687

  5. Fatigue, burnout, and chronic fatigue syndrome among employees on sick leave: do attributions make the difference?

    NARCIS (Netherlands)

    Huibers, M.J.H.; Beurskens, A.J.H.M.; Prins, J.B.; Kant, I.J.; Bazelmans, H.M.; Schayck, C.P. van; Knottnerus, J.A.; Bleijenberg, G.

    2003-01-01

    BACKGROUND: Persistent fatigue among employees, burnout, and chronic fatigue syndrome (CFS) are three fatigue conditions that share some characteristics in theory. However, these conditions have not been compared in empirical research, despite conceptual similarities. METHODS: This cross sectional

  6. Fatigue, burnout, and chronic fatigue syndrome among employees on sick leave: do attributions make the difference?

    NARCIS (Netherlands)

    Huibers, M.J.H.; Beurskens, A.J.H.M.; Prins, J.B.; Kant, I.J.; Bazelmans, H.M.; Schayck, C.P. van; Knottnerus, J.A.; Bleijenberg, G.

    2003-01-01

    BACKGROUND: Persistent fatigue among employees, burnout, and chronic fatigue syndrome (CFS) are three fatigue conditions that share some characteristics in theory. However, these conditions have not been compared in empirical research, despite conceptual similarities. METHODS: This cross sectional s

  7. [Chronic fatigue syndrome: biochemical examination of blood].

    Science.gov (United States)

    Hakariya, Yukiko; Kuratsune, Hirohiko

    2007-06-01

    Though patients with chronic fatigue syndrome (CFS) have lots of complaints, abnormal findings cannot be detected by biochemical screening tests. However, some specialized blood tests have revealed neuroendocrine immune axis abnormalities, which is closely associated with each other. Recent studies indicate that CFS can be understood as a special condition based on abnormality of the psycho-neuro-endocrino-immunological system, with the distinguishing feature of CFS seeming to be the secondary brain dysfunction caused by several cytokines and/or autoantibodies. In this paper, we summarize these abnormalities found in CFS and show the neuro-molecular mechanism leading to chronic fatigue.

  8. Elevated Energy Production in Chronic Fatigue Syndrome Patients

    OpenAIRE

    Lawson, Nick; Hsieh, Chung-Han; March, Dana; Wang, Xinnan

    2016-01-01

    Chronic Fatigue Syndrome (CFS) is a debilitating disease characterized by physical and mental exhaustion. The underlying pathogenesis is unknown, but impairments in certain mitochondrial functions have been found in some CFS patients. To thoroughly reveal mitochondrial deficiencies in CFS patients, here we examine the key aspects of mitochondrial function in blood cells from a paired CFS patient-control series. Surprisingly, we discover that in patients the ATP levels are higher and mitochond...

  9. Gray Matter Volumes in Patients with Chronic Fatigue Syndrome

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    Le-wei Tang

    2015-01-01

    Full Text Available Chronic fatigue syndrome (CFS is a debilitating and complex disorder characterized by profound fatigue with uncertain pathologic mechanism. Neuroimage may be an important key to unveil the central nervous system (CNS mechanism in CFS. Although most of the studies found gray matter (GM volumes reduced in some brain regions in CFS, there are many factors that could affect GM volumes in CFS, including chronic pain, stress, psychiatric disorder, physical activity, and insomnia, which may bias the results. In this paper, through reviewing recent literatures, we discussed these interferential factors, which overlap with the symptoms of CFS.

  10. Tryptophan depletion in chronic fatigue syndrome, a pilot cross-over study

    NARCIS (Netherlands)

    The, G.K.H.; Verkes, R.J.; Fekkes, D.; Bleijenberg, G.; Meer, J.W. van der; Buitelaar, J.K.

    2014-01-01

    BACKGROUND: Chronic fatigue syndrome (CFS) is still an enigmatic disorder. CFS can be regarded as a complex disorder with tremendous impact on lives of CFS-patients. Full recovery without treatment is rare.A somatic explanation for the fatigue is lacking. There is clinical and experimental evidence

  11. Tryptophan depletion in chronic fatigue syndrome, a pilot cross-over study

    NARCIS (Netherlands)

    G.K.H. The (Gerard K.H.); R.J. Verkes (Robbert); D. Fekkes (Durk); G. Bleijenberg (G.); J.W.M. van der Meer (Jos); J.K. Buitelaar (Jan)

    2014-01-01

    textabstractBackground: Chronic fatigue syndrome (CFS) is still an enigmatic disorder. CFS can be regarded as a complex disorder with tremendous impact on lives of CFS-patients. Full recovery without treatment is rare. A somatic explanation for the fatigue is lacking. There is clinical and experimen

  12. Pain in patients with chronic fatigue syndrome: time for specific pain treatment?

    NARCIS (Netherlands)

    Nijs, J.; Crombez, G.; Meeus, M.; Knoop, H.; Damme, S.V.; Cauwenbergh, V.; Bleijenberg, G.

    2012-01-01

    BACKGROUND: Besides chronic fatigue, patients with chronic fatigue syndrome (CFS) have debilitating widespread pain. Yet pain from CFS is often ignored by clinicians and researchers. OBJECTIVES: To examine whether pain is a unique feature of CFS, or does it share the same underlying mechanisms as ot

  13. Chronic Fatigue Syndrome (CFS): General Information

    Science.gov (United States)

    ... health care practitioners, who might include rehabilitation specialists, mental health professionals, and physical or exercise therapists. Together, they can create an individualized treatment ...

  14. Chronic Fatigue Syndrome (CFS): Childhood Adversity

    Science.gov (United States)

    ... reports of childhood abuse and neglect were investigated. Childhood trauma, defined as abuse, neglect, or loss, is a ... the lifespan. In various animal and human studies childhood trauma has been associated with low resting cortisol levels, ...

  15. Understanding Muscle Dysfunction in Chronic Fatigue Syndrome

    Directory of Open Access Journals (Sweden)

    Gina Rutherford

    2016-01-01

    Full Text Available Introduction. Chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME is a debilitating disorder of unknown aetiology, characterised by severe disabling fatigue in the absence of alternative diagnosis. Historically, there has been a tendency to draw psychological explanations for the origin of fatigue; however, this model is at odds with findings that fatigue and accompanying symptoms may be explained by central and peripheral pathophysiological mechanisms, including effects of the immune, oxidative, mitochondrial, and neuronal pathways. For example, patient descriptions of their fatigue regularly cite difficulty in maintaining muscle activity due to perceived lack of energy. This narrative review examined the literature for evidence of biochemical dysfunction in CFS/ME at the skeletal muscle level. Methods. Literature was examined following searches of PUB MED, MEDLINE, and Google Scholar, using key words such as CFS/ME, immune, autoimmune, mitochondria, muscle, and acidosis. Results. Studies show evidence for skeletal muscle biochemical abnormality in CFS/ME patients, particularly in relation to bioenergetic dysfunction. Discussion. Bioenergetic muscle dysfunction is evident in CFS/ME, with a tendency towards an overutilisation of the lactate dehydrogenase pathway following low-level exercise, in addition to slowed acid clearance after exercise. Potentially, these abnormalities may lead to the perception of severe fatigue in CFS/ME.

  16. Understanding Muscle Dysfunction in Chronic Fatigue Syndrome.

    Science.gov (United States)

    Rutherford, Gina; Manning, Philip; Newton, Julia L

    2016-01-01

    Introduction. Chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) is a debilitating disorder of unknown aetiology, characterised by severe disabling fatigue in the absence of alternative diagnosis. Historically, there has been a tendency to draw psychological explanations for the origin of fatigue; however, this model is at odds with findings that fatigue and accompanying symptoms may be explained by central and peripheral pathophysiological mechanisms, including effects of the immune, oxidative, mitochondrial, and neuronal pathways. For example, patient descriptions of their fatigue regularly cite difficulty in maintaining muscle activity due to perceived lack of energy. This narrative review examined the literature for evidence of biochemical dysfunction in CFS/ME at the skeletal muscle level. Methods. Literature was examined following searches of PUB MED, MEDLINE, and Google Scholar, using key words such as CFS/ME, immune, autoimmune, mitochondria, muscle, and acidosis. Results. Studies show evidence for skeletal muscle biochemical abnormality in CFS/ME patients, particularly in relation to bioenergetic dysfunction. Discussion. Bioenergetic muscle dysfunction is evident in CFS/ME, with a tendency towards an overutilisation of the lactate dehydrogenase pathway following low-level exercise, in addition to slowed acid clearance after exercise. Potentially, these abnormalities may lead to the perception of severe fatigue in CFS/ME.

  17. The economic impact of chronic fatigue syndrome

    Directory of Open Access Journals (Sweden)

    Bouchery Ellen

    2004-06-01

    Full Text Available Abstract Background Chronic fatigue syndrome (CFS is a chronic incapacitating illness that affects between 400,000 and 800,000 Americans. Despite the disabling nature of this illness, scant research has addressed the economic impact of CFS either on those affected or on the national economy. Methods We used microsimulation methods to analyze data from a surveillance study of CFS in Wichita, Kansas, and derive estimates of productivity losses due to CFS. Results We estimated a 37% decline in household productivity and a 54% reduction in labor force productivity among people with CFS. The annual total value of lost productivity in the United States was $9.1 billion, which represents about $20,000 per person with CFS or approximately one-half of the household and labor force productivity of the average person with this syndrome. Conclusion Lost productivity due to CFS was substantial both on an individual basis and relative to national estimates for other major illnesses. CFS resulted in a national productivity loss comparable to such losses from diseases of the digestive, immune and nervous systems, and from skin disorders. The extent of the burden indicates that continued research to determine the cause and potential therapies for CFS could provide substantial benefit both for individual patients and for the nation.

  18. Personality features and personality disorders in chronic fatigue syndrome: a population-based study

    OpenAIRE

    Nater, U.M.; Jones, J F; Lin, J-M S; Maloney, E; Reeves, W. C.; Heim, C.

    2010-01-01

    BACKGROUND: Chronic fatigue syndrome (CFS) presents unique diagnostic and management challenges. Personality may be a risk factor for CFS and may contribute to the maintenance of the illness. METHODS: 501 study participants were identified from the general population of Georgia: 113 people with CFS, 264 with unexplained unwellness but not CFS (insufficient fatigue, ISF) and 124 well controls. We used the Personality Diagnostic Questionnaire, 4th edition, to evaluate DSM-IV personality disorde...

  19. CHRONIC FATIGUE SYNDROME: APPROACHES TO DIAGNOSTICS AND THERAPY

    Directory of Open Access Journals (Sweden)

    N. M. Kalinina

    2011-01-01

    Full Text Available Abstract. The data on clinical symptoms in patients with chronic fatigue syndrome (CFS as well as some immunopathogenesis mechanisms of this disease are discussed in the article. Moreover, own research results on immunological changes in CFS patients have been described.

  20. Recognizing Family Dynamics in the Treatment of Chronic Fatigue Syndrome

    Science.gov (United States)

    Sperry, Len

    2012-01-01

    Chronic fatigue syndrome (CFS) is an increasingly common chronic medical condition that affects not only patients but also their families. Because family dynamics, particularly the family life cycle, can and does influence the disease process, those providing counseling to CFS patients and their families would do well to recognize these dynamics.…

  1. Chronic fatigue syndrome--a controlled cross sectional study

    DEFF Research Database (Denmark)

    Rasmussen, A K; Nielsen, H; Andersen, V

    1994-01-01

    OBJECTIVE. To look for signs of immunodeficiencies and/or longstanding infections underlying chronic fatigue syndrome (CFS). METHODS. Twenty-one patients fulfilling the Centers for Disease Control criteria for CFS were compared to 21 age and sex matched controls. A number of viral antibodies...

  2. Electroencephalographic correlates of Chronic Fatigue Syndrome

    Directory of Open Access Journals (Sweden)

    Reeves William C

    2009-10-01

    Full Text Available Abstract Background Unremitting fatigue and unrefreshing sleep, hallmark traits of Chronic Fatigue Syndrome (CFS, are also pathognomonic of sleep disorders. Yet, no reproducible perturbations of sleep architecture, multiple sleep latency times or Epworth Sleepiness Scores are found to be associated consistently with CFS. This led us to hypothesize that sleep homeostasis, rather than sleep architecture, may be perturbed in CFS. To probe this hypothesis, we measured and compared EEG frequencies associated with restorative sleep between persons with CFS and matched controls, both derived from a population-based sample. Methods We evaluated overnight polysomnography (PSG in 35 CFS and 40 control subjects. PSG records were manually scored and epochs containing artifact removed. Fast Fourier Transformation was utilized to deconstruct individual EEG signals into primary frequency bands of alpha, delta, theta, sigma, and beta frequency domains. The spectral power of each frequency domain for each sleep state was compared between persons with CFS and matched controls. Results In persons with CFS, delta power was diminished during slow wave sleep, but elevated during both stage 1 and REM. Alpha power was reduced during stage 2, slow wave, and REM sleep. Those with CFS also had significantly lower theta, sigma, and beta spectral power during stage 2, Slow Wave Sleep, and REM. Discussion Employing quantitative EEG analysis we demonstrate reduced spectral power of cortical delta activity during SWS. We also establish reduced spectral power of cortical alpha activity, with the greatest reduction occurring during REM sleep. Reductions in theta, beta, and sigma spectral power were also apparent. Conclusion Unremitting fatigue and unrefreshing sleep, the waking manifestations of CFS, may be the consequence of impaired sleep homeostasis rather than a primary sleep disorder.

  3. [Impact of the fibromyalgia in the chronic fatigue syndrome].

    Science.gov (United States)

    Faro, Mónica; Sáez-Francàs, Naia; Castro-Marrero, Jesús; Aliste, Luisa; Collado, Antonio; Alegre, José

    2014-06-16

    Different studies have showed association of the chronic fatigue syndrome (CFS) with other pathologies, including fibromyalgia (FM). The objective of this study is to analyze whether there are differences in the clinic and in the assessment of fatigue in CFS patients associated or not with FM. A cross-sectional, single-site observational study was undertaken on a consecutive cases of a register of CFS patients at CFS Unit in Vall d'Hebron Hospital, Barcelona, from January 2008 until March 2011. The variables analyzed were FM comorbidity, sleep and fatigue characteristics and cognitive, neurological and autonomic symptoms. Questionnaires of fatigue impact scale, fatigue strength and impact on quality of life SF-36 were evaluated. We included 980 CFS patients (mean age: 48±9 years; 91% women). Fibromyalgia was present in 528 patients (54%). The level of fatigue (P=.001) and pain (P<.001) was higher in FM patients. Patients with CFS and FM had more prevalence of sleep-related phenomena. The percentage of patients and the degree of severity of cognitive symptoms, neurological and autonomic dysfunction was higher in FM patients (P<.001). FM patients scored higher on the fatigue impact scale (P<.001) and showed worse results in the quality of life questionnaire (P<.001). FM co-morbidity worse clinical parameters, fatigue and the perception of quality of life in CFS patients. Copyright © 2013 Elsevier España, S.L. All rights reserved.

  4. Chronic Fatigue Syndrome in Adolescents: treatment, clinical features and epidemiology

    NARCIS (Netherlands)

    Nijhof, S.L.|info:eu-repo/dai/nl/314091904

    2013-01-01

    This thesis describes the treatment, epidemiology and clinical features of the adolescent chronic fatigue syndrome (CFS). Fatigue is a common complaint among adolescents, with a reported incidence of up to 20% in girls. This fatigue however is not chronic, does not debilitate and has an identifiable

  5. Traditional Chinese Medicine for Chronic Fatigue Syndrome

    Directory of Open Access Journals (Sweden)

    Rui Chen

    2010-01-01

    Full Text Available More and more patients have been diagnosed as having chronic fatigue syndrome (CFS in recent years. Western drug use for this syndrome is often associated with many side-effects and little clinical benefit. As an alternative medicine, traditional Chinese medicine (TCM has provided some evidences based upon ancient texts and recent studies, not only to offer clinical benefit but also offer insights into their mechanisms of action. It has perceived advantages such as being natural, effective and safe to ameliorate symptoms of CFS such as fatigue, disordered sleep, cognitive handicaps and other complex complaints, although there are some limitations regarding the diagnostic standards and methodology in related clinical or experimental studies. Modern mechanisms of TCM on CFS mainly focus on adjusting immune dysfunction, regulating abnormal activity in the hypothalamic-pituitary-adrenal (HPA axis and serving as an antioxidant. It is vitally important for the further development to establish standards for ‘zheng’ of CFS, i.e. the different types of CFS pathogenesis in TCM, to perform randomized and controlled trials of TCM on CFS and to make full use of the latest biological, biochemical, molecular and immunological approaches in the experimental design.

  6. Cognitive Impairments Associated with CFS and POTS

    Directory of Open Access Journals (Sweden)

    Leonard A. Jason

    2013-05-01

    Full Text Available Chronic fatigue syndrome (CFS is characterized by fatigue, sleep dysfunction, and cognitive deficits (Fukuda et al., 1994. Research surrounding cognitive functioning among patients with CFS has found difficulty with memory, attention, and information processing. A similar disorder, postural tachycardia syndrome (POTS, is characterized by increased heart rate, fatigue, and mental cloudiness (Raj et al., 2009. Potential implications of cognitive deficits for patients with CFS and/or POTS are discussed, including difficulties with school and/or employment. A few biological theories (i.e., kindling, impairments in the central nervous system, and difficulty with blood flow have emerged as potential explanations for the cognitive deficits reported in both CFS and POTS Future research should continue to examine possible explanations for cognitive impairments in CFS and POTS, and ultimately use this information to try and reduce cognitive impairments for these patients.

  7. DNA methylation modifications associated with chronic fatigue syndrome.

    Directory of Open Access Journals (Sweden)

    Wilfred C de Vega

    Full Text Available Chronic Fatigue Syndrome (CFS, also known as myalgic encephalomyelitis, is a complex multifactorial disease that is characterized by the persistent presence of fatigue and other particular symptoms for a minimum of 6 months. Symptoms fail to dissipate after sufficient rest and have major effects on the daily functioning of CFS sufferers. CFS is a multi-system disease with a heterogeneous patient population showing a wide variety of functional disabilities and its biological basis remains poorly understood. Stable alterations in gene function in the immune system have been reported in several studies of CFS. Epigenetic modifications have been implicated in long-term effects on gene function, however, to our knowledge, genome-wide epigenetic modifications associated with CFS have not been explored. We examined the DNA methylome in peripheral blood mononuclear cells isolated from CFS patients and healthy controls using the Illumina HumanMethylation450 BeadChip array, controlling for invariant probes and probes overlapping polymorphic sequences. Gene ontology (GO and network analysis of differentially methylated genes was performed to determine potential biological pathways showing changes in DNA methylation in CFS. We found an increased abundance of differentially methylated genes related to the immune response, cellular metabolism, and kinase activity. Genes associated with immune cell regulation, the largest coordinated enrichment of differentially methylated pathways, showed hypomethylation within promoters and other gene regulatory elements in CFS. These data are consistent with evidence of multisystem dysregulation in CFS and implicate the involvement of DNA modifications in CFS pathology.

  8. Evidence for a heritable predisposition to Chronic Fatigue Syndrome

    Directory of Open Access Journals (Sweden)

    Bateman Lucinda

    2011-05-01

    Full Text Available Abstract Background Chronic Fatigue Syndrome (CFS came to attention in the 1980s, but initial investigations did not find organic causes. Now decades later, the etiology of CFS has yet to be understood, and the role of genetic predisposition in CFS remains controversial. Recent reports of CFS association with the retrovirus xenotropic murine leukemic virus-related virus (XMRV or other murine leukemia related retroviruses (MLV might also suggest underlying genetic implications within the host immune system. Methods We present analyses of familial clustering of CFS in a computerized genealogical resource linking multiple generations of genealogy data with medical diagnosis data of a large Utah health care system. We compare pair-wise relatedness among cases to expected relatedness in the Utah population, and we estimate risk for CFS for first, second, and third degree relatives of CFS cases. Results We observed significant excess relatedness of CFS cases compared to that expected in this population. Significant excess relatedness was observed for both close (p Conclusions These analyses provide strong support for a heritable contribution to predisposition to Chronic Fatigue Syndrome. A population of high-risk CFS pedigrees has been identified, the study of which may provide additional understanding.

  9. Internet-based therapy for adolescents with chronic fatigue syndrome: long-term follow-up

    NARCIS (Netherlands)

    Nijhof, S.L.; Priesterbach, L.P.; Uiterwaal, C.S.; Bleijenberg, G.; Kimpen, J.L.L.; Putte, E.M. van de

    2013-01-01

    OBJECTIVE: Cognitive behavioral therapy (CBT) is known to be an effective treatment of adolescents with chronic fatigue syndrome (CFS), but its availability is limited. Fatigue in Teenagers on the Internet (FITNET), an Internet-based CBT program for adolescents with CFS, has been developed as an alt

  10. Personality dimensions in chronic fatigue syndrome and depression.

    Science.gov (United States)

    Buckley, L; MacHale, S M; Cavanagh, J T; Sharpe, M; Deary, I J; Lawrie, S M

    1999-04-01

    Chronic fatigue syndrome (CFS) is a poorly understood condition. Possible etiological factors include infectious agents, psychiatric disorders, and personality characteristics. We examined personality dimensions in 30 nondepressed patients with CFS, 20 patients with major depressive disorder (MDD), and 15 healthy controls. On the NEO-FFI, patients with CFS scored significantly lower than healthy controls on the extroversion subscale. On the neuroticism dimension of the Eysenck Personality Questionnaire (EPQ), patients with MDD scored higher than those with CFS, who in turn scored significantly higher than the healthy controls. CFS patients rated themselves as higher on neuroticism and less extroverted when ill than when they were well. Our results suggest that high scores on neuroticism and low scores on extroversion in CFS could be a reaction to chronic illness.

  11. Vitamin and mineral status in chronic fatigue syndrome and fibromyalgia syndrome : A systematic review and meta-analysis

    NARCIS (Netherlands)

    Joustra, Monica L.; Minovic, Isidor; Janssens, Karin A. M.; Bakker, Stephan J. L.; Rosmalen, Judith G. M.

    2017-01-01

    Background Many chronic fatigue syndrome (CFS) and fibromyalgia syndrome (FMS) patients (35-68%) use nutritional supplements, while it is unclear whether deficiencies in vitamins and minerals contribute to symptoms in these patients. Objectives were (1) to determine vitamin and mineral status in CFS

  12. The effect of a polynutrient supplement on fatigue and physical activity of patients with chronic fatigue syndrome: a double-blind randomized controlled trial.

    NARCIS (Netherlands)

    Brouwers, F.M.; Werf, S.P. van der; Bleijenberg, G.; Zee, L. van der; Meer, J.W.M. van der

    2002-01-01

    BACKGROUND:The efficacy of dietary supplements in chronic fatigue syndrome (CFS) is uncertain, with conflicting evidence. Aim: To assess the effect of a polynutrient supplement on fatigue and physical activity of patients with CFS. DESIGN:Prospective randomized placebo-controlled, double-blind

  13. Cytokine inhibition in chronic fatigue syndrome patients: study protocol for a randomized controlled trial

    NARCIS (Netherlands)

    Roerink, M.E.; Knoop, H.; Bredie, S.J.H.; Heijnen, M.; Joosten, L.A.B.; Netea, M.G.; Dinarello, C.A.; Meer, J.W.M. van der

    2015-01-01

    BACKGROUND: Chronic fatigue syndrome (CFS) is a medically unexplained syndrome for which no somatic or pharmacological treatment has been proven effective. Dysfunction of the cytokine network has been suspected to play a role in the pathophysiology of CFS. The disturbances of the cytokine network de

  14. Acute phase phospholipids related to the cardiolipin of mitochondria in the sera of patients with chronic fatigue syndrome (CFS), chronic Ciguatera fish poisoning (CCFP), and other diseases attributed to chemicals, Gulf War, and marine toxins.

    Science.gov (United States)

    Hokama, Yoshitsugi; Empey-Campora, Cara; Hara, Cynthia; Higa, Nicole; Siu, Nathaniel; Lau, Rachael; Kuribayashi, Tina; Yabusaki, Kenichi

    2008-01-01

    This study examined 328 CFS sera in a study with 17 CCFP, 8 Gulf War Veterans (GWV), 24 Prostate Cancer (PC), and 52 normal sera in the modified Membrane Immunobead Assay (MIA) procedure for CTX. Three hundred and twenty-eight CFS patients' sera were examined by the modified MIA with purified MAb-CTX and 91.2% gave a titre > or =1:40. 76% of the 17 CCFP sera samples and 100% of the 8 GWV sera samples also had a titre > or =1:40. 92.3% of 52 normal sera showed titres of 1:20 or less, while 4 gave titres of > or =1:40. In addition, 41 sera were examined for Anti-Cardiolipin (aCL) by a commercial ELISA procedure with 87.8% demonstrating IgM, IgM+IgA, or IgM+IgG aCL antibodies. These results showed mostly the IgM aCL antibody alone in the sera samples. In addition, 41 serum samples were examined for aCL, with 37 showing positive for aCL, representing 90.2% positive for the three disease categories examined: CFS, CCFP and GWV. Examination for antiMitochondrial-M2 autoantibody (aM-M2) in 28 patients (CFS (18), CCFP (5), and GWV (5)) was negative for aM-M2. Inhibition analysis with antigens, CTX, CFS "Acute Phase Lipids", commercial Cardiolipin (CL) and 1,2-Dipalmitoyl-sn-Glycero-3-[Phospho-L-Serine] (PS) and antibodies, MAb-CTX and aCL from patients' serum show that the phospholipids in CL and CTX are antigenically indistinguishable with antibodies MAb-CTX and CFS-aCL. Preliminary chemical analyses have shown the lipids to be phospholipids associated with CL of the mitochondria. We designate this "Acute Phase Lipid" comparable to "Acute Phase Proteins" (C-reactive protein (CRP) and Serum Amyloid A (SAA)) in inflammatory conditions.

  15. Differential effects of childhood trauma subtypes on fatigue and physical functioning in chronic fatigue syndrome.

    Science.gov (United States)

    De Venter, Maud; Illegems, Jela; Van Royen, Rita; Moorkens, Greta; Sabbe, Bernard G C; Van Den Eede, Filip

    2017-07-19

    There is wide consensus that childhood trauma plays an important role in the aetiology of chronic fatigue syndrome (CFS). The current study examines the differential effects of childhood trauma subtypes on fatigue and physical functioning in individuals suffering from CFS. Participants were 155 well-documented adult, predominantly female CFS patients receiving treatment at the outpatient treatment centre for CFS of the Antwerp University Hospital in Belgium. Stepwise regression analyses were conducted with outcomes of the total score of the Checklist Individual Strength (CIS) measuring fatigue and the scores on the physical functioning subscale of the Medical Outcomes Short Form 36 Health Status Survey (SF-36) as the dependent variables, and the scores on the five subscales of the Traumatic Experiences Checklist (TEC) as the independent variables. The patients' fatigue (β=1.38; p=0.025) and physical functioning scores (β=-1.79; p=0.034) were significantly predicted by childhood sexual harassment. There were no significant effects of emotional neglect, emotional abuse, bodily threat, or sexual abuse during childhood. Of the childhood trauma subtypes investigated, sexual harassment emerged as the most important predictor of fatigue and poor physical functioning in the CFS patients assessed. These findings have to be taken into account in further clinical research and in the assessment and treatment of individuals coping with chronic fatigue syndrome. Copyright © 2017 Elsevier Inc. All rights reserved.

  16. Demographic and clinical aspects of an Italian patient population with chronic fatigue syndrome

    Directory of Open Access Journals (Sweden)

    N. Carlo-Stella

    2011-06-01

    Full Text Available Chronic Fatigue Syndrome (CFS is a debilitating syndrome characterized by fatigue which, by exclusion, cannot be ascribed to another illness. Because of the vagueness of the symptoms and signs in patients with CFS, various attempts have been made to define the syndrome and classification criteria have been developed (1- 3, of which the most well-known and used are those of Fukuda et al. (1 This classification includes two major criteria...

  17. Gender differences in chronic fatigue syndrome.

    Science.gov (United States)

    Faro, Mònica; Sàez-Francás, Naia; Castro-Marrero, Jesús; Aliste, Luisa; Fernández de Sevilla, Tomás; Alegre, José

    2016-01-01

    Chronic fatigue syndrome (CFS) is a chronic condition that predominantly affects women. To date, there are few epidemiologic studies on CFS in men. The objective of the study was to assess whether there are gender-related differences in CFS, and to define a clinical phenotype in men. A prospective, cross-sectional cohort study was conducted including CFS patients at the time of diagnosis. Sociodemographic data, clinical variables, comorbid phenomena, fatigue, pain, anxiety/depression, and health quality of life, were assessed in the CFS population. A comparative study was also conducted between genders. The study included 1309 CFS patients, of which 119 (9.1%) were men. The mean age and symptoms onset were lower in men than women. The subjects included 30% single men vs. 15% single women, and 32% of men had specialist work vs. 20% of women. The most common triggering factor was an infection. Widespread pain, muscle spasms, dizziness, sexual dysfunction, Raynaud's phenomenon, morning stiffness, migratory arthralgias, drug and metals allergy, and facial oedema were less frequent in men. Fibromyalgia was present in 29% of men vs. 58% in women. The scores on physical function, physical role, and overall physical health of the SF-36 were higher in men. The sensory and affective dimensions of pain were lower in men. The clinical phenotype of the men with CFS was young, single, skilled worker, and infection as the main triggering agent. Men had less pain and less muscle and immune symptoms, fewer comorbid phenomena, and a better quality of life. Copyright © 2014 Elsevier España, S.L.U. y Sociedad Española de Reumatología y Colegio Mexicano de Reumatología. All rights reserved.

  18. Understanding self-experience in adolescent chronic fatigue syndrome

    NARCIS (Netherlands)

    van Geelen, S.M.

    2010-01-01

    A striking feature of the chronic fatigue syndrome (CFS) is the lack of consistent findings of pathology. While there has been a continuing search for the etiology and pathogenesis of the syndrome, there has been relatively little interest in a clarification of the experiential phenomena underlying

  19. Comorbidity of postural orthostatic tachycardia syndrome and chronic fatigue syndrome in an Australian cohort.

    Science.gov (United States)

    Reynolds, G K; Lewis, D P; Richardson, A M; Lidbury, B A

    2014-04-01

    Patients with chronic fatigue syndrome (CFS) are frequently diagnosed with comorbid postural orthostatic tachycardia syndrome (POTS), suggesting a shared pathogenesis. The aim of this study was to examine the relationship between demographic characteristics, autonomic functioning and fatigue levels amongst CFS patients with and without comorbid POTS. All patients presenting to the CFS Discovery Clinic between 2009 and 2012 completed a 20-min standing task as part of their initial assessment. Heart rate and pulse pressure were recorded at baseline, at 2-min intervals poststanding, at the end of the task and following a recovery period. Average heart rate and pulse pressure variability were calculated from this data. Age, gender, length of illness and self-reported fatigue scores were also recorded. POTS patients were diagnosed by an orthostatic increase in heart rate >30 beats per min, concomitant symptoms of orthostatic intolerance and no orthostatic hypotension. Differences in autonomic functioning between POTS and CFS patients were compared using independent samples t-tests, whilst logistic and linear regressions were performed to examine the contribution of autonomic functioning to task completion and perceived fatigue, respectively. Comorbidity of CFS and POTS (CFS-POTS) was observed in 11% (33/306) of patients. CFS-POTS patients were significantly younger (P changes (P = 0.002) and overall heart rate change (P general. © 2013 The Association for the Publication of the Journal of Internal Medicine.

  20. Differences in physical functioning between relatively active and passive patients with Chronic Fatigue Syndrome.

    NARCIS (Netherlands)

    Vos-Vromans, D.C.; Huijnen, I.P.; Koke, A.J.; Seelen, H.A.; Knottnerus, J.A.; Smeets, R.J.P.

    2013-01-01

    OBJECTIVE: According to the Cognitive behavioral therapy (CBT) protocol for patients with Chronic Fatigue Syndrome (CFS), therapists are advised to categorize patients in relatively active and passive patients. However, evidence to support the differences in physical functioning between these subgro

  1. Deviations in daily physical activity patterns in patients with the chronic fatigue syndrome: A case control study

    NARCIS (Netherlands)

    Evering, R.M.H.; Tönis, Thijs; Vollenbroek-Hutten, Miriam Marie Rosé

    2011-01-01

    Deviations in daily physical activity patterns may play an important role in the development and maintenance of fatigue in the chronic fatigue syndrome (CFS). The aim of this study is to gain insight into the objective daily physical activity pattern of patients with CFS in comparison with healthy

  2. [Medical certification of chronic fatigue syndrome].

    Science.gov (United States)

    Hausotter, W

    2015-03-01

    Chronic fatigue or chronic fatigue syndrome (CFS) is not a new disease, yet in recent years it has become increasingly important as an evaluation problem. It coincides with the well-known clinical picture of neurasthenia, shows extensive overlap with symptoms of depression and, finally, to the current concept of "burnout". Regarding the etiology there is fierce controversy between the representatives of a somatic and a psychological etiology. As reviewers you will be guided by the assessment criteria for somatoform disorders, especially because objectified findings are lacking. CFS can be independently encoded as neurological diagnosis G 93.3 according to ICD-10, although never objectified neurological deficits were detected, as well as neurasthenia F 48.0 or accompanying physical symptoms as somatization disorder F 45.0.

  3. Decreased basal ganglia activation in subjects with chronic fatigue syndrome: association with symptoms of fatigue.

    Directory of Open Access Journals (Sweden)

    Andrew H Miller

    Full Text Available Reduced basal ganglia function has been associated with fatigue in neurologic disorders, as well as in patients exposed to chronic immune stimulation. Patients with chronic fatigue syndrome (CFS have been shown to exhibit symptoms suggestive of decreased basal ganglia function including psychomotor slowing, which in turn was correlated with fatigue. In addition, CFS patients have been found to exhibit increased markers of immune activation. In order to directly test the hypothesis of decreased basal ganglia function in CFS, we used functional magnetic resonance imaging to examine neural activation in the basal ganglia to a reward-processing (monetary gambling task in a community sample of 59 male and female subjects, including 18 patients diagnosed with CFS according to 1994 CDC criteria and 41 non-fatigued healthy controls. For each subject, the average effect of winning vs. losing during the gambling task in regions of interest (ROI corresponding to the caudate nucleus, putamen, and globus pallidus was extracted for group comparisons and correlational analyses. Compared to non-fatigued controls, patients with CFS exhibited significantly decreased activation in the right caudate (p = 0.01 and right globus pallidus (p = 0.02. Decreased activation in the right globus pallidus was significantly correlated with increased mental fatigue (r2 = 0.49, p = 0.001, general fatigue (r2 = 0.34, p = 0.01 and reduced activity (r2 = 0.29, p = 0.02 as measured by the Multidimensional Fatigue Inventory. No such relationships were found in control subjects. These data suggest that symptoms of fatigue in CFS subjects were associated with reduced responsivity of the basal ganglia, possibly involving the disruption of projections from the globus pallidus to thalamic and cortical networks.

  4. Chronic musculoskeletal pain in patients with the chronic fatigue syndrome: a systematic review.

    Science.gov (United States)

    Meeus, Mira; Nijs, Jo; Meirleir, Kenny De

    2007-05-01

    In addition to debilitating fatigue the majority of patients with chronic fatigue syndrome (CFS) experience chronic widespread pain. Conducting a systematic review to critically assess the existing knowledge on chronic pain in CFS. We focussed on the definition, the prevalence and incidence, the aetiology, the relevance and the therapy strategy for chronic musculoskeletal pain and post-exertional pain in CFS. To identify relevant articles, we searched eight medical search engines. The search terms "chronic fatigue syndrome" AND "pain", "nociception", "arthralgia" and "myalgia", were used to identify articles concerning pain in CFS. Included articles were reviewed by two blinded researchers. Twenty-five articles and two abstract were identified and selected for further appraisal. Only 11 search results focussed on musculoskeletal pain in CFS patients. Regarding the standardized review of the articles, a 96% agreement between the researchers was observed. There is no consensus in defining chronic widespread pain in CFS, and although there is little or no strong proof for the exact prevalence, chronic pain is strongly disabling in CFS. Aetiological theories are proposed (sleep abnormalities, tryptophan, parovirus-B, hormonal and brain abnormalities and central sensitisation) and a reduction of pain threshold after exercise has been shown. Furthermore depression seemed not related to pain in CFS and a staphylococcus toxoid vaccine caused no significant pain reduction. The results from the systematic review highlight the clinical importance of chronic pain in CFS, but only few studies addressing the aetiology or treatment of chronic pain in CFS are currently available.

  5. Fibromyalgia, chronic fatigue syndrome, and myofascial pain syndrome.

    Science.gov (United States)

    Buskila, D

    2001-03-01

    The prevalence of chronic widespread pain in the general population in Israel was comparable with reports from the USA, UK, and Canada. Comorbidity with fibromyalgia (FM) resulted in somatic hyperalgesia in patients with irritable bowel syndrome. One sixth of the subjects with chronic widespread pain in the general population were also found to have a mental disorder. Mechanisms involved in referred pain, temporal summation, muscle hyperalgesia, and muscle pain at rest were attenuated by the N-methyl-D-aspartate (NMDA) antagonist, ketamine, in FM patients. Delayed corticotropin release, after interleukin-6 administration, in FM was shown to be consistent with a defect in hypothalamic corticotropin-releasing hormone neural function. The basal autonomic state of FM patients was characterized by increased sympathetic and decreased parasympathetic systems tones. The severity of functional impairment as assessed by the Medical Outcome Survey Short Form (SF-36) discriminated between patients with widespread pain alone and FM patients. Chronic fatigue syndrome (CFS) occurred in about 0.42% of a random community-based sample of 28,673 adults in Chicago, Illinois. A significant clinical overlap between CFS and FM was reported. Cytokine dysregulation was not found to be a singular or dominant factor in the pathogenesis of CFS. A favorable outcome of CFS in children was reported; two thirds recovered and resumed normal activities. No major therapeutic trials in FM and CFS were reported over the past year.

  6. The effect of acclydine in chronic fatigue syndrome: a randomized controlled trial.

    NARCIS (Netherlands)

    The, G.K.H.; Bleijenberg, G.; Meer, J.W.M. van der

    2007-01-01

    OBJECTIVES: It is unclear whether insulin-like growth factor (IGF) function is involved in the pathophysiology of chronic fatigue syndrome (CFS). Unpublished data and reports in patient organization newsletters suggest that Acclydine, a food supplement, could be effective in the treatment of CFS by

  7. Caring for People with Chronic Fatigue Syndrome: Perceived Stress Versus Satisfaction.

    Science.gov (United States)

    Ferrari, Joseph R.; Jason, Leonard A.

    1997-01-01

    Examined adult caregivers (N=96) caring for persons with Chronic Fatigue Syndrome (CFS) on a long-term basis. Results indicate no significant sex difference regarding caregiver stress and satisfaction. The more life satisfaction caregivers reported, the less stress and more satisfaction they experienced in caring for a person with CFS. (RJM)

  8. Family Health and Characteristics in Chronic Fatigue Syndrome, Juvenile Rheumatoid Arthritis, and Emotional Disorders of Childhood.

    Science.gov (United States)

    Rangel, Luiza; Garralda, M. Elena; Jeffs, Jim; Rose, Gillian

    2005-01-01

    Objective: To compare family health and characteristics in children with chronic fatigue syndrome (CFS), in juvenile rheumatoid arthritis (JRA), and emotional disorders. Method: Parents of 28 children and adolescents aged 11 to 18 years with CFS, 30 with JRA, and 27 with emotional disorders (i.e., anxiety and/or depressive disorders) were…

  9. Implementing Cognitive Behavioral Therapy for Chronic Fatigue Syndrome in a Mental Health Center: A Benchmarking Evaluation

    Science.gov (United States)

    Scheeres, Korine; Wensing, Michel; Knoop, Hans; Bleijenberg, Gijs

    2008-01-01

    Objective: This study evaluated the success of implementing cognitive behavioral therapy (CBT) for chronic fatigue syndrome (CFS) in a representative clinical practice setting and compared the patient outcomes with those of previously published randomized controlled trials (RCTs) of CBT for CFS. Method: The implementation interventions were the…

  10. Metabolic features of chronic fatigue syndrome

    Science.gov (United States)

    Naviaux, Robert K.; Naviaux, Jane C.; Li, Kefeng; Bright, A. Taylor; Alaynick, William A.; Wang, Lin; Baxter, Asha; Nathan, Neil; Anderson, Wayne; Gordon, Eric

    2016-01-01

    More than 2 million people in the United States have myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). We performed targeted, broad-spectrum metabolomics to gain insights into the biology of CFS. We studied a total of 84 subjects using these methods. Forty-five subjects (n = 22 men and 23 women) met diagnostic criteria for ME/CFS by Institute of Medicine, Canadian, and Fukuda criteria. Thirty-nine subjects (n = 18 men and 21 women) were age- and sex-matched normal controls. Males with CFS were 53 (±2.8) y old (mean ± SEM; range, 21–67 y). Females were 52 (±2.5) y old (range, 20–67 y). The Karnofsky performance scores were 62 (±3.2) for males and 54 (±3.3) for females. We targeted 612 metabolites in plasma from 63 biochemical pathways by hydrophilic interaction liquid chromatography, electrospray ionization, and tandem mass spectrometry in a single-injection method. Patients with CFS showed abnormalities in 20 metabolic pathways. Eighty percent of the diagnostic metabolites were decreased, consistent with a hypometabolic syndrome. Pathway abnormalities included sphingolipid, phospholipid, purine, cholesterol, microbiome, pyrroline-5-carboxylate, riboflavin, branch chain amino acid, peroxisomal, and mitochondrial metabolism. Area under the receiver operator characteristic curve analysis showed diagnostic accuracies of 94% [95% confidence interval (CI), 84–100%] in males using eight metabolites and 96% (95% CI, 86–100%) in females using 13 metabolites. Our data show that despite the heterogeneity of factors leading to CFS, the cellular metabolic response in patients was homogeneous, statistically robust, and chemically similar to the evolutionarily conserved persistence response to environmental stress known as dauer. PMID:27573827

  11. Chronic Fatigue Syndrome – A clinically empirical approach to its definition and study

    Directory of Open Access Journals (Sweden)

    Papanicolaou Dimitris A

    2005-12-01

    Full Text Available Abstract Background The lack of standardized criteria for defining chronic fatigue syndrome (CFS has constrained research. The objective of this study was to apply the 1994 CFS criteria by standardized reproducible criteria. Methods This population-based case control study enrolled 227 adults identified from the population of Wichita with: (1 CFS (n = 58; (2 non-fatigued controls matched to CFS on sex, race, age and body mass index (n = 55; (3 persons with medically unexplained fatigue not CFS, which we term ISF (n = 59; (4 CFS accompanied by melancholic depression (n = 27; and (5 ISF plus melancholic depression (n = 28. Participants were admitted to a hospital for two days and underwent medical history and physical examination, the Diagnostic Interview Schedule, and laboratory testing to identify medical and psychiatric conditions exclusionary for CFS. Illness classification at the time of the clinical study utilized two algorithms: (1 the same criteria as in the surveillance study; (2 a standardized clinically empirical algorithm based on quantitative assessment of the major domains of CFS (impairment, fatigue, and accompanying symptoms. Results One hundred and sixty-four participants had no exclusionary conditions at the time of this study. Clinically empirical classification identified 43 subjects as CFS, 57 as ISF, and 64 as not ill. There was minimal association between the empirical classification and classification by the surveillance criteria. Subjects empirically classified as CFS had significantly worse impairment (evaluated by the SF-36, more severe fatigue (documented by the multidimensional fatigue inventory, more frequent and severe accompanying symptoms than those with ISF, who in turn had significantly worse scores than the not ill; this was not true for classification by the surveillance algorithm. Conclusion The empirical definition includes all aspects of CFS specified in the 1994 case definition and identifies persons with

  12. Immune and hemorheological changes in Chronic Fatigue Syndrome

    Directory of Open Access Journals (Sweden)

    Ashton Kevin J

    2010-01-01

    Full Text Available Abstract Background Chronic Fatigue Syndrome (CFS is a multifactorial disorder that affects various physiological systems including immune and neurological systems. The immune system has been substantially examined in CFS with equivocal results, however, little is known about the role of neutrophils and natural killer (NK phenotypes in the pathomechanism of this disorder. Additionally the role of erythrocyte rheological characteristics in CFS has not been fully expounded. The objective of this present study was to determine deficiencies in lymphocyte function and erythrocyte rheology in CFS patients. Methods Flow cytometric measurements were performed for neutrophil function, lymphocyte numbers, NK phenotypes (CD56dimCD16+ and CD56brightCD16- and NK cytotoxic activity. Erythrocyte aggregation, deformability and fibrinogen levels were also assessed. Results CFS patients (n = 10 had significant decreases in neutrophil respiratory burst, NK cytotoxic activity and CD56brightCD16- NK phenotypes in comparison to healthy controls (n = 10. However, hemorheological characteristic, aggregation, deformability, fibrinogen, lymphocyte numbers and CD56dimCD16+ NK cells were similar between the two groups. Conclusion These results indicate immune dysfunction as potential contributors to the mechanism of CFS, as indicated by decreases in neutrophil respiratory burst, NK cell activity and NK phenotypes. Thus, immune cell function and phenotypes may be important diagnostic markers for CFS. The absence of rheological changes may indicate no abnormalities in erythrocytes of CFS patients.

  13. Subgrouping Chronic Fatigue Syndrome Patients By Genetic and Immune Profiling

    Science.gov (United States)

    2015-12-01

    SUBJECT TERMS CyTOF, human leukocyte antigens (HLA) types, Chronic Fatigue Syndrome(CFS), novel testing, autoimmune disease , dynamic range, analytes...Pathology, Stanford University School of Medicine, and co-Director of the Histocompatibility, Immunogenetics and Disease Profiling Laboratory. Dr...HLA Disease Associations Website, The Autoimmune Disease Site, http://www.hladiseaseassociations.com/ autoimmune - diseases -and-hla/rheumatoid

  14. The role of hypocortisolism in chronic fatigue syndrome

    NARCIS (Netherlands)

    Nijhof, S.L.; Rutten, J.M.; Uiterwaal, C.S.; Bleijenberg, G.; Kimpen, J.L.L.; Putte, E.M. van de

    2014-01-01

    BACKGROUND: There is accumulating evidence of hypothalamic-pituitary-adrenal (HPA) axis hypofunction in chronic fatigue syndrome (CFS). However, knowledge of this hypofunction has so far come exclusively from research in adulthood, and its clinical significance remains unclear. The objective of the

  15. Chronic fatigue syndrome and sleep disorders: clinical associations and diagnostic difficulties.

    Science.gov (United States)

    Ferré, A

    2016-02-11

    Chronic fatigue syndrome (CFS) is characterised by the presence of intractable fatigue and non-restorative sleep, symptoms which are also very prevalent in multiple diseases and appear as side effects of different drugs. Numerous studies have shown a high prevalence of sleep disorders in patients with CFS. However, non-restorative sleep and fatigue are frequently symptoms of the sleep disorders themselves, so primary sleep disorders have to be ruled out in many cases of CFS. This review was performed using a structured search of the MeSH terms ([Sleep]+[Chronic fatigue syndrome]) in the PubMed database. Identifying primary sleep disorders in patients meeting diagnostic criteria for CFS will allow for a more comprehensive treatment approach involving new diagnostic and therapeutic strategies that may improve quality of life for these patients. Copyright © 2016 Sociedad Española de Neurología. Published by Elsevier España, S.L.U. All rights reserved.

  16. Fatigue In Teenagers on the interNET--the FITNET Trial. A randomized clinical trial of web-based cognitive behavioural therapy for adolescents with chronic fatigue syndrome: study protocol. [ISRCTN59878666

    NARCIS (Netherlands)

    Nijhof, S.L.; Bleijenberg, G.; Uiterwaal, C.S.; Kimpen, J.L.L.; Putte, E.M. van de

    2011-01-01

    BACKGROUND: Chronic Fatigue Syndrome (CFS) is increasingly recognized as a cause of disability and inactivity in adolescents in the Netherlands. CFS is characterized by unexplained fatigue lasting more than 6 months. Cognitive Behavioural Therapy (CBT) has proven to be effective. However, CBT availa

  17. Obesity in adolescents with chronic fatigue syndrome: an observational study.

    Science.gov (United States)

    Norris, T; Hawton, K; Hamilton-Shield, J; Crawley, E

    2017-01-01

    Identify the prevalence of obesity in patients with chronic fatigue syndrome (CFS) compared with healthy adolescents, and those identified with CFS in a population cohort. Cross-sectional analysis of multiple imputed data. Data from UK paediatric CFS/myalgic encephalomyelitis (CFS/ME) services compared with data collected at two time points in the Avon Longitudinal Study of Parents and Children (ALSPAC). 1685 adolescents who attended a CFS/ME specialist service between 2004 and 2014 and 13 978 adolescents aged approximately 13 years and 16 years participating in the ALSPAC study. Body mass index (BMI) (kg/m(2)), sex-specific and age-specific BMI Z-scores (relative to the International Obesity Task Force cut-offs) and prevalence of obesity (%). Adolescents who had attended specialist CFS/ME services had a higher prevalence of obesity (age 13 years: 9.28%; age 16 years: 16.43%) compared with both adolescents classified as CFS/ME in ALSPAC (age 13 years: 3.72%; age 16 years: 5.46%) and those non-CFS in ALSPAC (age 13 years: 4.18%; age 16 years: 4.46%). The increased odds of obesity in those who attended specialist services (relative to non-CFS in ALSPAC) was apparent at both 13 years (OR: 2.31 (1.54 to 3.48)) and 16 years, with a greater likelihood observed at 16 years (OR: 4.07 (2.04 to 8.11)). We observed an increased prevalence of obesity in adolescents who were affected severely enough to be referred to a specialist CFS/ME service. Further longitudinal research is required in order to identify the temporal relationship between the two conditions. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  18. Chronic fatigue syndrome and circulating cytokines: A systematic review.

    Science.gov (United States)

    Blundell, S; Ray, K K; Buckland, M; White, P D

    2015-11-01

    There has been much interest in the role of the immune system in the pathophysiology of chronic fatigue syndrome (CFS), as CFS may develop following an infection and cytokines are known to induce acute sickness behaviour, with similar symptoms to CFS. Using the PRISMA (Preferred Reporting Items for Systematic reviews and Meta-analyses) guidelines, a search was conducted on PubMed, Web of Science, Embase and PsycINFO, for CFS related-terms in combination with cytokine-related terms. Cases had to meet established criteria for CFS and be compared with healthy controls. Papers retrieved were assessed for both inclusionary criteria and quality. 38 papers met the inclusionary criteria. The quality of the studies varied. 77 serum or plasma cytokines were measured without immune stimulation. Cases of CFS had significantly elevated concentrations of transforming growth factor-beta (TGF-β) in five out of eight (63%) studies. No other cytokines were present in abnormal concentrations in the majority of studies, although insufficient data were available for some cytokines. Following physical exercise there were no differences in circulating cytokine levels between cases and controls and exercise made no difference to already elevated TGF-β concentrations. The finding of elevated TGF-β concentration, at biologically relevant levels, needs further exploration, but circulating cytokines do not seem to explain the core characteristic of post-exertional fatigue.

  19. Plasma neuropeptide Y: a biomarker for symptom severity in chronic fatigue syndrome

    Directory of Open Access Journals (Sweden)

    Harvey Jeanna M

    2010-12-01

    Full Text Available Abstract Background Chronic fatigue syndrome (CFS is a complex, multi-symptom illness with a multisystem pathogenesis involving alterations in the nervous, endocrine and immune systems. Abnormalities in stress responses have been identified as potential triggers or mediators of CFS symptoms. This study focused on the stress mediator neuropeptide Y (NPY. We hypothesized that NPY would be a useful biomarker for CFS. Methods The CFS patients (n = 93 were from the Chronic Fatigue and Related Disorders Clinic at the University of Miami and met the 1994 case definition of Fukuda and colleagues. Healthy sedentary controls (n = 100 were from NIH or VA funded studies. Another fatiguing, multi-symptom illness, Gulf War Illness (GWI, was also compared to CFS. We measured NPY in plasma using a radioimmunoassay (RIA. Psychometric measures, available for a subset of CFS patients included: Perceived Stress Scale, Profile of Mood States, ATQ Positive & Negative Self-Talk Scores, the COPE, the Beck Depression Inventory, Fatigue Symptom Inventory, Cognitive Capacity Screening Examination, Medical Outcomes Survey Short Form-36, and the Quality of Life Scale. Results Plasma NPY was elevated in CFS subjects, compared to controls (p = .000 and to GWI cases (p = .000. Receiver operating characteristics (ROC curve analyses indicated that the predictive ability of plasma NPY to distinguish CFS patients from healthy controls and from GWI was significantly better than chance alone. In 42 patients with CFS, plasma NPY had significant correlations ( Conclusions This study is the first in the CFS literature to report that plasma NPY is elevated compared to healthy controls and to a fatigued comparison group, GWI patients. The significant correlations of NPY with stress, negative mood, general health, depression and cognitive function strongly suggest that this peptide be considered as a biomarker to distinguish subsets of CFS.

  20. Chronic musculoskeletal pain in chronic fatigue syndrome: recent developments and therapeutic implications.

    Science.gov (United States)

    Nijs, Jo; Meeus, Mira; De Meirleir, Kenny

    2006-08-01

    Patients with chronic fatigue syndrome (CFS) experience chronic musculoskeletal pain which is even more debilitating than fatigue. Scientific research data gathered around the world enables clinicians to understand, at least in part, chronic musculoskeletal pain in CFS patients. Generalized joint hypermobility and benign joint hypermobility syndrome appear to be highly prevalent among CFS sufferers, but they do not seem to be of any clinical importance. On the other hand, pain catastrophizing accounts for a substantial portion of musculoskeletal pain and is a predictor of exercise performance in CFS patients. The evidence concerning pain catastrophizing is supportive of the indirect evidence of a dysfunctional pain processing system in CFS patients with musculoskeletal pain. CFS sufferers respond to incremental exercise with a lengthened and accentuated oxidative stress response, explaining muscle pain, postexertional malaise, and the decrease in pain threshold following graded exercise in CFS patients. Applying the scientific evidence to the manual physiotherapy profession, pacing self-management techniques and pain neurophysiology education are indicated for the treatment of musculoskeletal pain in CFS patients. Studies examining the effectiveness of these strategies for CFS patients are warranted.

  1. Chronic Fatigue Syndrome (CFS): Managing Activities and Exercise

    Science.gov (United States)

    ... impact (light) activity can then be added. Simple stretching and strengthening exercise using only body weight for ... of motion. Activity should begin slowly with simple stretching and strengthening exercises. Examples of functional exercises include ...

  2. Helping Your Child Manage Chronic Fatigue Syndrome (CFS)

    Science.gov (United States)

    ... concerns you have with your child in school. Work closely with teachers, counselors, and other school staff ... be difficult for them to participate in the classroom, or attend school on a regular basis. With ...

  3. Chronic Fatigue Syndrome (CFS): Treating the Most Disruptive Symptoms First

    Science.gov (United States)

    ... psychological disorder may warrant a referral to a mental health professional. In addition, deep breathing and muscle relaxation techniques, massage and healing touch, and movement therapies like stretching, yoga and tai chi can be beneficial for some ...

  4. Multivitamin mineral supplementation in patients with chronic fatigue syndrome

    Science.gov (United States)

    Maric, Daniela; Brkic, Snezana; Mikic, Aleksandra Novakov; Tomic, Slavica; Cebovic, Tatjana; Turkulov, Vesna

    2014-01-01

    Background Chronic fatigue syndrome (CFS) is characterized by medically unexplained persistent or reoccurring fatigue lasting at least 6 months. CFS has a multifactorial pathogenesis in which oxidative stress (OS) plays a prominent role. Treatment is with a vitamin and mineral supplement, but this therapeutic option so far has not been properly researched. Material/Methods This prospective study included 38 women of reproductive age consecutively diagnosed by CDC definition of CFS and treated with a multivitamin mineral supplement. Before and after the 2-month supplementation, SOD activity was determined and patients self-assessed their improvement in 2 questionnaires: the Fibro Fatigue Scale (FFS) and the Quality of Life Scale (SF36). Results There was a significant improvement in SOD activity levels; and significant decreases in fatigue (p=0.0009), sleep disorders (p=0.008), autonomic nervous system symptoms (p=0.018), frequency and intensity of headaches (p=0.0001), and subjective feeling of infection (p=0.0002). No positive effect on quality of life was found. Conclusions Treatment with a vitamin and mineral supplement could be a safe and easy way to improve symptoms and quality of life in patients with CFS. PMID:24419360

  5. Integration of gene expression, clinical, and epidemiologic data to characterize Chronic Fatigue Syndrome

    Directory of Open Access Journals (Sweden)

    Vernon Suzanne D

    2003-12-01

    Full Text Available Abstract Background Chronic fatigue syndrome (CFS has no diagnostic clinical signs or diagnostic laboratory abnormalities and it is unclear if it represents a single illness. The CFS research case definition recommends stratifying subjects by co-morbid conditions, fatigue level and duration, or functional impairment. But to date, this analysis approach has not yielded any further insight into CFS pathogenesis. This study used the integration of peripheral blood gene expression results with epidemiologic and clinical data to determine whether CFS is a single or heterogeneous illness. Results CFS subjects were grouped by several clinical and epidemiological variables thought to be important in defining the illness. Statistical tests and cluster analysis were used to distinguish CFS subjects and identify differentially expressed genes. These genes were identified only when CFS subjects were grouped according to illness onset and the majority of genes were involved in pathways of purine and pyrimidine metabolism, glycolysis, oxidative phosphorylation, and glucose metabolism. Conclusion These results provide a physiologic basis that suggests CFS is a heterogeneous illness. The differentially expressed genes imply fundamental metabolic perturbations that will be further investigated and illustrates the power of microarray technology for furthering our understanding CFS.

  6. Inflammatory and oxidative and nitrosative stress cascades as new drug targets in myalgic encephalomyelitis and chronic fatigue syndrome.

    Science.gov (United States)

    Maes, Michael

    2013-01-01

    Myalgic encephalomyelitis (ME), chronic fatigue syndrome (CFS) and chronic fatigue (CF) are distinct diagnostic categories with regard to clinical symptoms, severity of illness and biomarkers. Patients with ME and CFS show higher scores on fatigue, neurocognitive disorders, hyperalgesia, autonomic symptoms, postexertional malaise and a subjective feeling of infection than patients with CF. ME is characterized by increased postexertional malaise, a subjective feeling of infection and neurocognitive disorders and is a more severe variant than CFS. Fukuda's 1994 CDC criteria are adequate to make a distinction between patients with ME/CFS and CF, while ME/CFS patients should be subdivided into those with and without postexertional malaise into ME and CFS, respectively. Different interrelated pathophysiological mechanisms play a role in ME/CFS, i.e. (1) inflammation and immune activation, (2) oxidative and nitrosative stress and lowered antioxidant defenses, (3) activation of cell signaling networks, e.g. nuclear factor ĸβ, the 2 9 ,5 9 -oligoadenylate/RNase-L and/or protein kinase R pathway, (4) a transition towards autoimmune reactions, and (5) bacterial translocation. The inflammatory biomarkers are higher in ME/CFS than in CF and higher in ME than in CFS. The above-mentioned pathways may explain the onset of characteristic ME/CFS symptoms, such as fatigue, malaise, autonomic symptoms, hyperalgesia, and neurocognitive symptoms. Different etiological factors may trigger ME/CFS/CF, e.g. viral and bacterial infections, and (auto)immune and inflammatory disorders, while psychosocial and physical stressors act as modulating factors. New pathophysiologically driven drug candidates for ME and CFS are discussed which target the pathways that play a role in ME/CFS. Copyright © 2013 S. Karger AG, Basel.

  7. Adolescent chronic fatigue syndrome; a follow-up study displays concurrent improvement of circulatory abnormalities and clinical symptoms

    OpenAIRE

    Sulheim Dag; Hurum Harald; Helland Ingrid B; Thaulow Erik; Wyller Vegard

    2012-01-01

    Background The pathophysiology of chronic fatigue syndrome (CFS) in adolescents is unknown, and the clinical course and prognosis is still questioned. Recent research indicates that abnormalities of autonomic cardiovascular control may play an important role. The aim of this research project was to perform a follow-up study of adolescents with chronic fatigue syndrome, focusing on clinical symptoms and autonomic cardiovascular control. ...

  8. Increasing orthostatic stress impairs neurocognitive functioning in chronic fatigue syndrome with postural tachycardia syndrome.

    Science.gov (United States)

    Ocon, Anthony J; Messer, Zachary R; Medow, Marvin S; Stewart, Julian M

    2012-03-01

    CFS (chronic fatigue syndrome) is commonly co-morbid with POTS (postural tachycardia syndrome). Individuals with CFS/POTS experience unrelenting fatigue, tachycardia during orthostatic stress and ill-defined neurocognitive impairment, often described as 'mental fog'. We hypothesized that orthostatic stress causes neurocognitive impairment in CFS/POTS related to decreased CBFV (cerebral blood flow velocity). A total of 16 CFS/POTS and 20 control subjects underwent graded tilt table testing (at 0, 15, 30, 45, 60 and 75°) with continuous cardiovascular, cerebrovascular, and respiratory monitoring and neurocognitive testing using an n-back task at each angle. The n-back task tests working memory, concentration, attention and information processing. The n-back task imposes increasing cognitive challenge with escalating (0-, 1-, 2-, 3- and 4-back) difficulty levels. Subject dropout due to orthostatic presyncope at each angle was similar between groups. There were no n-back accuracy or RT (reaction time) differences between groups while supine. CFS/POTS subjects responded less correctly during the n-back task test and had greater nRT (normalized RT) at 45, 60 and 75°. Furthermore, at 75° CFS/POTS subjects responded less correctly and had greater nRT than controls during the 2-, 3- and 4-back tests. Changes in CBFV were not different between the groups and were not associated with n-back task test scores. Thus we conclude that increasing orthostatic stress combined with a cognitive challenge impairs the neurocognitive abilities of working memory, accuracy and information processing in CFS/POTS, but that this is not related to changes in CBFV. Individuals with CFS/POTS should be aware that orthostatic stress may impair their neurocognitive abilities.

  9. Distinctive personality profiles of fibromyalgia and chronic fatigue syndrome patients

    Science.gov (United States)

    Zohar, Ada H.; Zaraya-Blum, Reut; Buskila, Dan

    2016-01-01

    Objective The current study is an innovative exploratory investigation, aiming at identifying differences in personality profiles within Fibromyalgia Syndrome (FMS) and Chronic Fatigue Syndrome (CFS) patients. Method In total, 344 participants (309 female, 35 male) reported suffering from FMS and/or CFS and consented to participate in the study. Participants were recruited at an Israeli FM/CFS patient meeting held in May 2013, and through an announcement posted on several social networks. Participants were asked to complete a research questionnaire, which included FMS criteria and severity scales, and measures of personality, emotional functioning, positivity, social support and subjective assessment of general health. In total, 204 participants completed the research questionnaire (40.7% attrition rate). Results A cluster analysis produced two distinct clusters, which differed significantly on psychological variables, but did not differ on demographic variables or illness severity. As compared to cluster number 2 (N = 107), participants classified into cluster number 1 (N = 97) showed a less adaptive pattern, with higher levels of Harm Avoidance and Alexithymia; higher prevalence of Type D personality; and lower levels of Persistence (PS), Reward dependence (RD), Cooperation, Self-directedness (SD), social support and positivity. Conclusion The significant pattern of results indicates at least two distinct personality profiles of FM and CFS patients. Findings from this research may help improve the evaluation and treatment of FM and CFS patients, based on each patient’s unique needs, psychological resources and weaknesses, as proposed by the current trend of personalized medicine. PMID:27672497

  10. Distinctive personality profiles of fibromyalgia and chronic fatigue syndrome patients

    Directory of Open Access Journals (Sweden)

    Jacob N. Ablin

    2016-09-01

    Full Text Available Objective The current study is an innovative exploratory investigation, aiming at identifying differences in personality profiles within Fibromyalgia Syndrome (FMS and Chronic Fatigue Syndrome (CFS patients. Method In total, 344 participants (309 female, 35 male reported suffering from FMS and/or CFS and consented to participate in the study. Participants were recruited at an Israeli FM/CFS patient meeting held in May 2013, and through an announcement posted on several social networks. Participants were asked to complete a research questionnaire, which included FMS criteria and severity scales, and measures of personality, emotional functioning, positivity, social support and subjective assessment of general health. In total, 204 participants completed the research questionnaire (40.7% attrition rate. Results A cluster analysis produced two distinct clusters, which differed significantly on psychological variables, but did not differ on demographic variables or illness severity. As compared to cluster number 2 (N = 107, participants classified into cluster number 1 (N = 97 showed a less adaptive pattern, with higher levels of Harm Avoidance and Alexithymia; higher prevalence of Type D personality; and lower levels of Persistence (PS, Reward dependence (RD, Cooperation, Self-directedness (SD, social support and positivity. Conclusion The significant pattern of results indicates at least two distinct personality profiles of FM and CFS patients. Findings from this research may help improve the evaluation and treatment of FM and CFS patients, based on each patient’s unique needs, psychological resources and weaknesses, as proposed by the current trend of personalized medicine.

  11. Chronic Fatigue Syndrome Treated by Acupuncture and Moxibustion in Combination with Psychological Approaches in 310 Cases

    Institute of Scientific and Technical Information of China (English)

    Guo Junhua

    2007-01-01

    Objective: To observe clinical therapeutic effect of acupuncture and moxibustion combined with a psychological approach on chronic fatigue syndrome (CFS). Methods: The treatment was given by acupuncture plus moxibustion combined with a psychological approach based on differentiation of symptoms and signs in 310 cases. Results: Of 310 cases observed, 275 cases (88.7%) were clinically cured,28 cases (9%) improved, and 7 cases (2.3%) failed. Conclusion: Acupuncture plus moxibustion combined with a psychological approach is an effective therapy for CFS.

  12. [Randomized controlled study on acupuncture treatment for chronic fatigue syndrome].

    Science.gov (United States)

    Chen, Xing-Hua; Li, Lu-Qian; Zhang, Wen; Yang, Juan; Dai, Yi-Shuang; Xu, Dong-Hua; Tang, Chun-Zhi

    2010-07-01

    To observe the therapeutic effect of acpuncture treatment for chronic fatigue syndrome (CFS). Nighty cases of CFS were randomly divided into an observation group and a control group, 45 cases in each group. The observation group was treated with acupunture at Renying (ST 9), Fengfu (GV 16), Baihui (GV 20); the control group was treated with 250 mL 5% Glucose injectio combined with 20 mL Shenmai injectio. Fatigue Scale (FS) was used to compare the scores between the two groups after treatment. The total scores in the observation group were 9.37 +/- 2.33 and 5.41 +/- 1.96 before and after treatment respectively, and in the control group, they were 9.08 +/- 2.27 and 7.34 +/- 2.03 respectively. FS brainwork integral, physical fatigue integral, and total integral all decreased after treatment in two groups (all P < 0.001), and it decreased much more obviously in the observation group (P < 0.05, P < 0.01). Both of the acpuncture treatment and Shenmai injectio are able to decrease fatigue scale score, improve the fatigue symptoms of CFS patients, and the effect of acupucture treatment is obviously superior to that of Shenmai injectio.

  13. Migraine in Gulf War Illness and Chronic Fatigue Syndrome: Prevalence, potential mechanisms, and evaluation

    Directory of Open Access Journals (Sweden)

    Rakib eRayhan

    2013-07-01

    Full Text Available Objective: To assess the prevalence of headache subtypes in Gulf War Illness and Chronic Fatigue Syndrome compared to controls. Background: Migraines are reported in Chronic Fatigue Syndrome (CFS. Approximately, 25% of the military personnel who served in the 1990-1991 Persian Gulf War have developed Gulf War Illness (GWI. Symptoms in GWI share considerable overlap with CFS, including headache complaints. The type and prevalence of headaches in GWI have not been adequately assessed.Methods: 50 GWI, 39 CFS and 45 controls were examined. Participants had structured headache evaluations based on the 2004 International Headache Society criteria. All subjects had history and physical examinations, measurements of systemic hyperalgesia (dolorimetry, assessments for exclusionary indicators, fatigue and symptom related questionnaires. Results: Migraines were detected in 64% of GWI (odds ratio, 11.6, [±95% CI, 4.1 to 32.5] and 82% of CFS subjects (odds ratio, 22.5, [±95% CI, 7.8 to 64.8] compared to only 13% of controls. There was a predominance of females in the CFS compared to GWI and controls. However, gender did not influence migraine status (x2= 2.7; P = 0.101. Measures of fatigue, pain, and other ancillary criteria were comparable between GWI and CFS subjects with and without headache. Conclusion: Results validate previous findings of migraine in CFS and confirms similar increased prevalence in GWI compared to controls. This suggests GWI and CFS subjects share pathophysiological mechanisms that underlie migraine attacks and contribute to the extensive overlap of symptom constructs and disease pathophysiology. The high migraine prevalence warrants the inclusion of a structured headache evaluation that coincides with clinical assessments of GWI and CFS diagnosis.

  14. Fatigue syndrome in sarcoidosis.

    Science.gov (United States)

    Górski, Witold; Piotrowski, Wojciech J

    2016-01-01

    Sarcoidosis is an inflammatory disease of unknown etiology. Most commonly it results in the formation of non-caseating granulomas in intrathoracic lymph nodes and lung parenchyma, but the clinical course and picture may be complicated by extrapulmonary involvement and many non-respiratory signs and symptoms which are directly related to the disease. In addition, sarcoidosis patients may suffer from a plethora of symptoms of uncertain or unknown origin. Fatigue is one of these symptoms, and according to some authors it is reported by the majority of patients with active sarcoidosis, but also by a smaller proportion of patients with inactive sarcoidosis, or even with complete clinical and radiological remission. Therefore the term fatigue syndrome is frequently used to name this clinical problem. The definition of fatigue syndrome in sarcoidosis is imprecise and the syndrome is usually recognized by use of validated questionnaires. In this review the uptodate knowledge in this field was presented and different challenges connected with this syndrome were described.

  15. The process of cognitive behaviour therapy for chronic fatigue syndrome: which changes in perpetuating cognitions and behaviour are related to a reduction in fatigue?

    NARCIS (Netherlands)

    Heins, M.J.; Knoop, H.; Burk, W.J.; Bleijenberg, G.

    2013-01-01

    Objective: Cognitive behaviour therapy (CBT) can significantly reduce fatigue in chronic fatigue syndrome (CFS), but little is known about the process of change taking place during CBT. Based on a recent treatment model (Wiborg et al. J Psych Res 2012), we examined how (changes in) cognitions and be

  16. The process of cognitive behaviour therapy for chronic fatigue syndrome: Which changes in perpetuating cognitions and behaviour are related to a reduction in fatigue?

    NARCIS (Netherlands)

    Heins, M.J.; Knoop, H.; Burk, W.J.; Bleijenberg, G.

    2013-01-01

    OBJECTIVE: Cognitive behaviour therapy (CBT) can significantly reduce fatigue in chronic fatigue syndrome (CFS), but little is known about the process of change taking place during CBT. Based on a recent treatment model (Wiborg et al. J Psych Res 2012), we examined how (changes in) cognitions and

  17. The process of cognitive behaviour therapy for chronic fatigue syndrome: which changes in perpetuating cognitions and behaviour are related to a reduction in fatigue?

    NARCIS (Netherlands)

    Heins, M.J.; Knoop, H.; Burk, W.J.; Bleijenberg, G.

    2013-01-01

    Objective: Cognitive behaviour therapy (CBT) can significantly reduce fatigue in chronic fatigue syndrome (CFS), but little is known about the process of change taking place during CBT. Based on a recent treatment model (Wiborg et al. J Psych Res 2012), we examined how (changes in) cognitions and

  18. The process of cognitive behaviour therapy for chronic fatigue syndrome: Which changes in perpetuating cognitions and behaviour are related to a reduction in fatigue?

    NARCIS (Netherlands)

    Heins, M.J.; Knoop, H.; Burk, W.J.; Bleijenberg, G.

    2013-01-01

    Objective: Cognitive behaviour therapy (CBT) can significantly reduce fatigue in chronic fatigue syndrome (CFS), but little is known about the process of change taking place during CBT. Based on a recent treatment model (Wiborg et al. J Psych Res 2012), we examined how (changes in) cognitions and

  19. Personality Features and Personality Disorders in Chronic Fatigue Syndrome: A Population-Based Study

    Science.gov (United States)

    Nater, Urs M.; Jones, James F.; Lin, Jin-Mann S.; Maloney, Elizabeth; Reeves, William C.; Heim, Christine

    2010-01-01

    Background Chronic fatigue syndrome (CFS) presents unique diagnostic and management challenges. Personality may be a risk factor for CFS and may contribute to the maintenance of the illness. Methods 501 study participants were identified from the general population of Georgia: 113 people with CFS, 264 with unexplained unwellness but not CFS (insufficient fatigue, ISF) and 124 well controls. We used the Personality Diagnostic Questionnaire, 4th edition, to evaluate DSM-IV personality disorders. We used the NEO Five-Factor Inventory to assess personality features (neuroticism, extraversion, openness, agreeableness and conscientiousness). The Multidimensional Fatigue Inventory measured 5 dimensions of fatigue, and the Medical Outcomes Survey Short Form 36 measured 8 dimensions of functional impairment. Results Twenty-nine percent of the CFS cases had at least 1 personality disorder, compared to 28% of the ISF cases and 7% of the well controls. The prevalence of paranoid, schizoid, avoidant, obsessive-compulsive and depressive personality disorders were significantly higher in CFS and ISF compared to the well controls. The CFS cases had significantly higher scores on neuroticism, and significantly lower scores on extraversion than those with ISF or the well controls. Personality features were correlated with selected composite characteristics of fatigue. Conclusions Our results suggest that CFS is associated with an increased prevalence of maladaptive personality features and personality disorders. This might be associated with being noncompliant with treatment suggestions, displaying unhealthy behavioral strategies and lacking a stable social environment. Since maladaptive personality is not specific to CFS, it might be associated with illness per se rather than with a specific condition. PMID:20664306

  20. Personality features and personality disorders in chronic fatigue syndrome: a population-based study.

    Science.gov (United States)

    Nater, Urs M; Jones, James F; Lin, Jin-Mann S; Maloney, Elizabeth; Reeves, William C; Heim, Christine

    2010-01-01

    Chronic fatigue syndrome (CFS) presents unique diagnostic and management challenges. Personality may be a risk factor for CFS and may contribute to the maintenance of the illness. 501 study participants were identified from the general population of Georgia: 113 people with CFS, 264 with unexplained unwellness but not CFS (insufficient fatigue, ISF) and 124 well controls. We used the Personality Diagnostic Questionnaire, 4th edition, to evaluate DSM-IV personality disorders. We used the NEO Five-Factor Inventory to assess personality features (neuroticism, extraversion, openness, agreeableness and conscientiousness). The Multidimensional Fatigue Inventory measured 5 dimensions of fatigue, and the Medical Outcomes Survey Short Form 36 measured 8 dimensions of functional impairment. Twenty-nine percent of the CFS cases had at least 1 personality disorder, compared to 28% of the ISF cases and 7% of the well controls. The prevalence of paranoid, schizoid, avoidant, obsessive-compulsive and depressive personality disorders were significantly higher in CFS and ISF compared to the well controls. The CFS cases had significantly higher scores on neuroticism, and significantly lower scores on extraversion than those with ISF or the well controls. Personality features were correlated with selected composite characteristics of fatigue. Our results suggest that CFS is associated with an increased prevalence of maladaptive personality features and personality disorders. This might be associated with being noncompliant with treatment suggestions, displaying unhealthy behavioral strategies and lacking a stable social environment. Since maladaptive personality is not specific to CFS, it might be associated with illness per se rather than with a specific condition. Copyright 2010 S. Karger AG, Basel.

  1. Gene expression in response to exercise in patients with chronic fatigue syndrome: a pilot study.

    Directory of Open Access Journals (Sweden)

    Andrew Keech

    2016-09-01

    Full Text Available Chronic fatigue syndrome (CFS is a debilitating disorder of unknown pathogenesis, characterised by fatigue, which is exacerbated after minimal exercise. We examined the effect of a single bout of aerobic exercise on leucocyte mRNA expression of genes putatively linked to exaggerated afferent signalling as an under-pinning of the fatigue state. A carefully-characterised sample of patients with CFS (N = 10 and healthy matched control participants (N = 12 were included. Participant ratings of fatigue and other symptoms, as well as blood samples, were obtained at baseline, and five other time-points up to 72 hours after 25 minutes of moderate-intensity cycling exercise. Leucocyte mRNA of 19 metabolite-sensing, adrenergic, immune and neurotransmission genes was examined using quantitative polymerase chain reaction. Patients with CFS reported substantial fatigue, functional impairment and poor sleep at baseline (all p < 0.02, and exercise immediately induced worsened patients’ fatigue (effect size, ES = 1.17. There were no significant changes in gene expression after exercise and patients did not differ from control participants at any time point. Higher levels of expression of ficolin (FCN1 and a purinergic receptor (P2RX4 in patients with CFS were found when all time points were combined. Patients with CFS did not show significant exercise-induced changes in leucocyte mRNA of 19 metabolite-sensing, adrenergic, immune and neurotransmission genes despite a prominent exacerbation of fatigue.

  2. Effects of Exercise on Behavior and Peripheral Blood Lymphocyte Apoptosis in a Rat Model of Chronic Fatigue Syndrome

    Institute of Scientific and Technical Information of China (English)

    邹军; 苑建齐; 吕爽; 屠嘉衡

    2010-01-01

    This study examined the effects of exercise on behavior and peripheral blood leukocyte apoptosis in a rat model of chronic fatigue syndrome(CFS).Thirty-six healthy male Sprague-Dawley rats were equally randomized into 3 groups:the control group,CFS model group and the exercise group in terms of body weight.A total of 25 rats entered the final statistical analysis due to 11 deaths during the study.CFS model was established by subjecting the rats in CFS model group and exercise group to electric shock,chronic...

  3. Treatment of 40 Cases of Chronic Fatigue Syndrome by Cupping Method

    Institute of Scientific and Technical Information of China (English)

    张水臣

    2009-01-01

    @@ Chronic fatigue syndrome (CFS) refers to a group of main manifestations characterized by chronic or recurrent severe fatigue,accompanied by headache,sore throat,muscular and joint pain,insomnia and multiple nervous and psychological symptoms,but without other chronic organic diseases and mental disorders.In 1987,it was termed formally by the United States Centers for Diseases Control.Currently,the etiology and pathogenesis of CFS are still unknown,and there is effective medication for it.The author has treated 40 cases of this syndrome by applying cupping method on Back-Shu points since 2005.Now,the report is given as follows.

  4. Reduced cardiac vagal modulation impacts on cognitive performance in chronic fatigue syndrome.

    Directory of Open Access Journals (Sweden)

    Alison Beaumont

    Full Text Available BACKGROUND: Cognitive difficulties and autonomic dysfunction have been reported separately in patients with chronic fatigue syndrome (CFS. A role for heart rate variability (HRV in cognitive flexibility has been demonstrated in healthy individuals, but this relationship has not as yet been examined in CFS. The objective of this study was to examine the relationship between HRV and cognitive performance in patients with CFS. METHODS: Participants were 30 patients with CFS and 40 healthy controls; the groups were matched for age, sex, education, body mass index, and hours of moderate exercise/week. Questionnaires were used to obtain relevant medical and demographic information, and assess current symptoms and functional impairment. Electrocardiograms, perceived fatigue/effort and performance data were recorded during cognitive tasks. Between-group differences in autonomic reactivity and associations with cognitive performance were analysed. RESULTS: Patients with CFS showed no deficits in performance accuracy, but were significantly slower than healthy controls. CFS was further characterized by low and unresponsive HRV; greater heart rate (HR reactivity and prolonged HR-recovery after cognitive challenge. Fatigue levels, perceived effort and distress did not affect cognitive performance. HRV was consistently associated with performance indices and significantly predicted variance in cognitive outcomes. CONCLUSIONS: These findings reveal for the first time an association between reduced cardiac vagal tone and cognitive impairment in CFS and confirm previous reports of diminished vagal activity.

  5. TCM Non-medicinal Therapy for Regulation and Treatment of Chronic Fatigue Syndrome

    Institute of Scientific and Technical Information of China (English)

    冯卓; 庞勇; 叶仿武; 黄国琪

    2008-01-01

    @@ Chronic fatigue syndrome (CFS) is a severe issue to influence the psychosomatic health of the mankind. With the social development, because of the enhancement of the medical and hygienic levels and improvement of the life quality, people pay an increasing attention to the issue of CFS. How to solve CFS, currently due to limitation in the theory of Western medicine, there is no concrete therapeutic method, in addition to the suggestion to change bad life style, regulate the psychological status and pay attention to proper balance between fatigue and physical exercise. But, TCM non-medicinal therapies have unique advantage and remarkable therapeutic effect in the elimination of CFS. Now, current-used TCM non-medicinal therapies for sub-health are summarized in the following.

  6. Can sustained arousal explain the Chronic Fatigue Syndrome?

    Directory of Open Access Journals (Sweden)

    Eriksen Hege R

    2009-02-01

    Full Text Available Abstract We present an integrative model of disease mechanisms in the Chronic Fatigue Syndrome (CFS, unifying empirical findings from different research traditions. Based upon the Cognitive activation theory of stress (CATS, we argue that new data on cardiovascular and thermoregulatory regulation indicate a state of permanent arousal responses – sustained arousal – in this condition. We suggest that sustained arousal can originate from different precipitating factors (infections, psychosocial challenges interacting with predisposing factors (genetic traits, personality and learned expectancies (classical and operant conditioning. Furthermore, sustained arousal may explain documented alterations by establishing vicious circles within immunology (Th2 (humoral vs Th1 (cellular predominance, endocrinology (attenuated HPA axis, skeletal muscle function (attenuated cortical activation, increased oxidative stress and cognition (impaired memory and information processing. Finally, we propose a causal link between sustained arousal and the experience of fatigue. The model of sustained arousal embraces all main findings concerning CFS disease mechanisms within one theoretical framework.

  7. Identification of ambiguities in the 1994 chronic fatigue syndrome research case definition and recommendations for resolution

    Directory of Open Access Journals (Sweden)

    Stouten Bart

    2005-05-01

    Full Text Available Abstract Background A recent article by Reeves et al. on the identification and resolution of ambiguities in the 1994 chronic fatigue syndrome (CFS research case definition recommended the Checklist Individual Strength, the Chalder Fatigue Scale, and the Krupp Fatigue Severity Scale for evaluating fatigue in CFS studies. To be able to discriminate between various levels of severe fatigue, extreme scoring on the individual items of these questionnaires must not occur too often. Methods We derived an expression that allows us to compute a lower bound for the number of items with the maximum item score for a given study from the reported mean scale score, the number of reported subjects, and the properties of the fatigue rating scale. Several CFS studies that used the recommended fatigue rating scales were selected from literature and analyzed to verify whether abundant extreme scoring had occurred. Results Extreme scoring occurred on a large number of the items for all three recommended fatigue rating scales across several studies. The percentage of items with the maximum score exceeded 40% in several cases. The amount of extreme scoring for a certain scale varied from one study to another, which suggests heterogeneity in the selected subjects across studies. Conclusion Because all three instruments easily reach the extreme ends of their scales on a large number of the individual items, they do not accurately represent the severe fatigue that is characteristic for CFS. This should lead to serious questions about the validity and suitability of the Checklist Individual Strength, the Chalder Fatigue Scale, and the Krupp Fatigue Severity Scale for evaluating fatigue in CFS research.

  8. Fatigue Fighters in Sjogren's Syndrome

    Science.gov (United States)

    Patient Education Sheet Fatigue Fighters in Sjögren’s Syndrome The SSF thanks Frederick Vivino, MD, FACR, University of Pennsylvania, Penn Rheumatology Associates & Sjögren’s Syndrome Center, Philadelphia, for authoring this Patient Education ...

  9. Cadmium and mialgic encephalomyelitis/chronic fatigue syndrome; application of transcranial sonography to the study of cadmium-induced neuronal damage

    OpenAIRE

    G.Morucci; Gulisano, M; Pacini, S; J.J.V. Branca; Ruggiero, M

    2012-01-01

    Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (CFS) is a neurological disease characterized by widespread inflammation and neuropathology. Aetiology and pathogenesis are unknown and it has been hypothesized that exposure to heavy metals is among the triggers of CFS. We recently hypothesized that cadmium, an occupational and environmental heavy metal pollutant, might be associated with some of the neurological findings typical of CFS. It is worth noticing that cadmium induces neuronal dea...

  10. Chronic Fatigue Syndrome

    Science.gov (United States)

    ... exercise in your daily routine. Exercise can provide healing movement, increased energy, and feelings of well-being. People with CFS should pace themselves while doing any physical activity that requires exertion. Everyone's level of tolerance is ...

  11. Effects of Qigong Exercise on Fatigue, Anxiety, and Depressive Symptoms of Patients with Chronic Fatigue Syndrome-Like Illness: A Randomized Controlled Trial

    Directory of Open Access Journals (Sweden)

    Jessie S. M. Chan

    2013-01-01

    Full Text Available Background. Anxiety/depressive symptoms are common in patients with chronic fatigue syndrome- (CFS- like illness. Qigong as a modality of complementary and alternative therapy has been increasingly applied by patients with chronic illnesses, but little is known about the effect of Qigong on anxiety/depressive symptoms of the patients with CFS-like illness. Purpose. To investigate the effects of Qigong on fatigue, anxiety, and depressive symptoms in patients with CFS-illness. Methods. One hundred and thirty-seven participants who met the diagnostic criteria for CFS-like illness were randomly assigned to either an intervention group or a waitlist control group. Participants in the intervention group received 10 sessions of Qigong training twice a week for 5 consecutive weeks, followed by home-based practice for 12 weeks. Fatigue, anxiety, and depressive symptoms were assessed at baseline and postintervention. Results. Total fatigue score [F1,135=13.888, P<0.001], physical fatigue score [F1,135=20.852, P<0.001] and depression score [F1,135=9.918, P=0.002] were significantly improved and mental fatigue score [F1,135=3.902, P=0.050] was marginally significantly improved in the Qigong group compared to controls. The anxiety score was not significantly improved in the Qigong group. Conclusion. Qigong may not only reduce the fatigue symptoms, but also has antidepressive effect for patients with CFS-like illness. Trial registration HKCTR-1200.

  12. Reduced heart rate variability predicts poor sleep quality in a case-control study of chronic fatigue syndrome.

    Science.gov (United States)

    Burton, A R; Rahman, K; Kadota, Y; Lloyd, A; Vollmer-Conna, U

    2010-07-01

    Parasympathetic function is important in the induction and maintenance of sleep. We examined whether nocturnal vagal modulation of heart rate is related to the poor sleep quality commonly reported in chronic fatigue syndrome (CFS). Heart rate (HR, as R-R intervals) was continuously monitored during sleep in 20 patients with CFS and 20 matched control subjects. Questionnaires assessed demographic information, symptoms, functional impairment, and subjective sleep quality. CFS was associated with more sleep problems in general and poorer subjective sleep quality on the study night (all p sleep were significantly lower in patients with CFS (all p heart rate variability (HRV) parameters were the best predictors of subjective sleep measures. This study identified significant reductions in vagal modulation of heart rate during sleep in CFS. Low HRV strongly predicted sleep quality-suggesting a pervasive state of nocturnal sympathetic hypervigilance in CFS.

  13. Mood and Anxiety Disorders in Chronic Fatigue Syndrome, Fibromyalgia, and Irritable Bowel Syndrome : Results From the LifeLines Cohort Study

    NARCIS (Netherlands)

    Janssens, Karin A. M.; Zijlema, Wilma L.; Joustra, Monica L.; Rosmalen, Judith G. M.

    2015-01-01

    Objective: Functional somatic syndromes (FSSs) have often been linked to psychopathology. The aim of the current study was to compare prevalence rates of psychiatric disorders among individuals with chronic fatigue syndrome (CFS), fibromyalgia (FM), and irritable bowel syndrome (IBS). Methods: This

  14. Immunophenotyping in post-giardiasis functional gastrointestinal disease and chronic fatigue syndrome

    Directory of Open Access Journals (Sweden)

    Hanevik Kurt

    2012-10-01

    Full Text Available Abstract Background A Giardia outbreak was associated with development of post-infectious functional gastrointestinal disorders (PI-FGID and chronic fatigue syndrome (PI-CFS. Markers of immune dysfunction have given conflicting results in CFS and FGID patient populations. The aim of this study was to evaluate a wide selection of markers of immune dysfunction in these two co-occurring post-infectious syndromes. Methods 48 patients, reporting chronic fatigue in a questionnaire study, were clinically evaluated five years after the outbreak and grouped according to Fukuda criteria for CFS (n=19 and idiopathic chronic fatigue (n=5 and Rome II criteria for FGIDs (n=54. 22 Giardia exposed non-fatigued individuals and 10 healthy unexposed individuals were recruited as controls. Peripheral blood lymphocyte subsets were analyzed by flow cytometry. Results In peripheral blood we found significantly higher CD8 T-cell levels in PI-FGID, and significantly lower NK-cell levels in PI-CFS patients. Severity of abdominal and fatigue symptoms correlated negatively with NK-cell levels. A tendency towards lower T-cell CD26 expression in FGID was seen. Conclusion Patients with PI-CFS and/or PI-FGID 5 years after Giardia lamblia infection showed alterations in NK-cell and CD8-cell populations suggesting a possible immunological abnormality in these conditions. We found no significant changes in other markers examined in this well-defined group of PI-CFS and PI-FGID elicited by a gastrointestinal infection. Controlling for co-morbid conditions is important in evaluation of CFS-biomarkers.

  15. Elimination of oral focal infection: a new solution in chronic fatigue syndrome management?

    Directory of Open Access Journals (Sweden)

    Haryono Utomo

    2005-12-01

    Full Text Available Chronic fatigue syndrome (CFS is an illness whose primary symptoms are debilitating fatigue and cognitive dysfunction. Substantial symptom overlaping with fibromyalgia, depression, allergic diseases, and many other illnesses, and the absence of a universally applicable diagnostic test, makes the diagnosis of CFS complex and challenging. The pathophysiology of CFS is also complex, and not clearly understood. Formerly, CFS was believed to be a variant form of depression, but due to an increasing body of evidence, CFS is now considered primarily as a biochemical derangement of the functioning of the neuroimmune and neuroendocrine systems. Recently, most treatments still primarily emphasize analgesics, anti inflammatory and psychiatric treatment which correlates to psychosomatic disorders. One of the symptoms that is poorly understood is allergy, but according to the neurogenic switching hypothesis the correlation can be explained nowadays. The role of oral focal infection as one of the possible etiology has still rarely been discussed. The goal of this article is to explain the possible pathophysiology of CFS which could be elicited by oral focal infection, especially endotoxin (lipopolysaccharide from gram negative bacteria. This case report discusses the history of illness, previous treatments, diagnosis, case management and treatment result. Periodontal treatment of a patient with symptom mimicking CFSs undergoing periodontal treatment has a remarkable result. The conclusion is that the elimination of oral focal infection could be a new solution in CFS management.

  16. High-throughput sequencing of plasma microRNA in chronic fatigue syndrome/myalgic encephalomyelitis.

    Directory of Open Access Journals (Sweden)

    Ekua W Brenu

    Full Text Available BACKGROUND: MicroRNAs (miRNAs are known to regulate many biological processes and their dysregulation has been associated with a variety of diseases including Chronic Fatigue Syndrome/Myalgic Encephalomyelitis (CFS/ME. The recent discovery of stable and reproducible miRNA in plasma has raised the possibility that circulating miRNAs may serve as novel diagnostic markers. The objective of this study was to determine the role of plasma miRNA in CFS/ME. RESULTS: Using Illumina high-throughput sequencing we identified 19 miRNAs that were differentially expressed in the plasma of CFS/ME patients in comparison to non-fatigued controls. Following RT-qPCR analysis, we were able to confirm the significant up-regulation of three miRNAs (hsa-miR-127-3p, hsa-miR-142-5p and hsa-miR-143-3p in the CFS/ME patients. CONCLUSION: Our study is the first to identify circulating miRNAs from CFS/ME patients and also to confirm three differentially expressed circulating miRNAs in CFS/ME patients, providing a basis for further study to find useful CFS/ME biomarkers.

  17. Myalgic Encephalomyelitis/Chronic Fatigue Syndrome Diagnosis and Management in Young People: A Primer.

    Science.gov (United States)

    Rowe, Peter C; Underhill, Rosemary A; Friedman, Kenneth J; Gurwitt, Alan; Medow, Marvin S; Schwartz, Malcolm S; Speight, Nigel; Stewart, Julian M; Vallings, Rosamund; Rowe, Katherine S

    2017-01-01

    Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a complex disease that affects children and adolescents as well as adults. The etiology has not been established. While many pediatricians and other health-care providers are aware of ME/CFS, they often lack essential knowledge that is necessary for diagnosis and treatment. Many young patients experience symptoms for years before receiving a diagnosis. This primer, written by the International Writing Group for Pediatric ME/CFS, provides information necessary to understand, diagnose, and manage the symptoms of ME/CFS in children and adolescents. ME/CFS is characterized by overwhelming fatigue with a substantial loss of physical and mental stamina. Cardinal features are malaise and a worsening of symptoms following minimal physical or mental exertion. These post-exertional symptoms can persist for hours, days, or weeks and are not relieved by rest or sleep. Other symptoms include cognitive problems, unrefreshing or disturbed sleep, generalized or localized pain, lightheadedness, and additional symptoms in multiple organ systems. While some young patients can attend school, on a full or part-time basis, many others are wheelchair dependent, housebound, or bedbound. Prevalence estimates for pediatric ME/CFS vary from 0.1 to 0.5%. Because there is no diagnostic test for ME/CFS, diagnosis is purely clinical, based on the history and the exclusion of other fatiguing illnesses by physical examination and medical testing. Co-existing medical conditions including orthostatic intolerance (OI) are common. Successful management is based on determining the optimum balance of rest and activity to help prevent post-exertional symptom worsening. Medications are helpful to treat pain, insomnia, OI and other symptoms. The published literature on ME/CFS and specifically that describing the diagnosis and management of pediatric ME/CFS is very limited. Where published studies are lacking, recommendations are based on the

  18. A paradigm linking herpesvirus immediate-early gene expression apoptosis and myalgic encephalomyelitis chronic fatigue syndrome

    Directory of Open Access Journals (Sweden)

    A Martin Lerner

    2011-02-01

    Full Text Available A Martin Lerner1, Safedin Beqaj21Department of Medicine, William Beaumont Hospital, Royal Oak, MI, USA; 2DCL Medical Laboratories, Indianapolis, IN, USAAbstract: There is no accepted science to relate herpesviruses (Epstein–Barr virus [EBV], human cytomegalovirus [HCMV], and human herpesvirus 6 [HHV6] as causes of myalgic encephalomyelitis (ME/chronic fatigue syndrome (CFS. ME/CFS patients have elevated serum immunoglobulin (IgG serum antibody titers to EBV, HCMV, and HHV6, but there is no herpesvirus DNA-emia, herpesvirus antigenemia, or uniformly elevated IgM serum antibody titers to the complete virions. We propose that herpesvirus EBV, HCMV, and HHV6 immediate-early gene expression in ME/CFS patients leads to host cell dysregulation and host cell apoptosis without lytic herpesvirus replication. Specific antiviral nucleosides, which alleviate ME/CFS, namely valacyclovir for EBV ME/CFS and valganciclovir for HCMV/HHV6 ME/CFS, inhibit herpesvirus DNA polymerases and/or thymidine kinase functions, thus inhibiting lytic virus replication. New host cell recruitment thus ceases. In the absence of new herpesvirus, nonpermissive herpesvirus replication stops, and ME/CFS recovery ensues.Keywords: ME/CFS, Epstein–Barr virus (EBV, human cytomegalovirus (HCMV, HHV6, abortive replication

  19. The relations among body consciousness, somatic symptom report, and information processing speed in chronic fatigue syndrome.

    NARCIS (Netherlands)

    Werf, S.P. van der; Vree, B.P.W. de; Meer, J.W.M. van der; Bleijenberg, G.

    2002-01-01

    OBJECTIVE: The aim of this study was to assess the potential influence of body consciousness and levels of somatic symptom report upon information processing speed in patients with chronic fatigue syndrome (CFS). BACKGROUND: According to a model of a fixed information processing capacity, it was

  20. Childhood maltreatment and the response to cognitive behavior therapy for chronic fatigue syndrome.

    NARCIS (Netherlands)

    Heins, M.J.; Knoop, H.; Lobbestael, J.; Bleijenberg, G.

    2011-01-01

    Objective: To examine the relationship between a history of childhood maltreatment and the treatment response to cognitive behavior therapy for chronic fatigue syndrome (CFS). Methods: A cohort study in a tertiary care clinic with a referred sample of 216 adult patients meeting the Centers for Disea

  1. Clinical Observation The Thoughts and Methods for Clinical Research on Acupuncture Treatment of Chronic Fatigue Syndrome

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    The general situation of chronic fatigue syndrome (CFS) and the criteria for its diagnosis are discussed, and it is put forward that making qi and blood of the zang-fu organs balanced is the key to acupuncture treatment of the disease. Such aspects as case selection, point selection and therapeutic assessment are also discussed in the present paper.

  2. Childhood maltreatment and the response to cognitive behavior therapy for chronic fatigue syndrome.

    NARCIS (Netherlands)

    Heins, M.J.; Knoop, H.; Lobbestael, J.; Bleijenberg, G.

    2011-01-01

    Objective: To examine the relationship between a history of childhood maltreatment and the treatment response to cognitive behavior therapy for chronic fatigue syndrome (CFS). Methods: A cohort study in a tertiary care clinic with a referred sample of 216 adult patients meeting the Centers for

  3. Childhood maltreatment and the response to cognitive behavior therapy for chronic fatigue syndrome

    NARCIS (Netherlands)

    Heins, M.J.; Knoop, H.; Lobbestael, J.; Bleijenberg, G.

    2011-01-01

    OBJECTIVE: To examine the relationship between a history of childhood maltreatment and the treatment response to cognitive behavior therapy for chronic fatigue syndrome (CFS). METHODS: A cohort study in a tertiary care clinic with a referred sample of 216 adult patients meeting the Centers for

  4. Moderators of the treatment response to guided self-instruction for chronic fatigue syndrome

    NARCIS (Netherlands)

    Tummers, M.J.; Knoop, H.; Dam, A. van; Bleijenberg, G.

    2013-01-01

    OBJECTIVE: The efficiency and efficacy of guided self-instruction for chronic fatigue syndrome (CFS) can be enhanced if it is known which patients will benefit from the intervention. This study aimed to identify moderators of treatment response. METHODS: This study is a secondary analysis of two

  5. Combined dexamethasone/corticotropin-releasing factor test in chronic fatigue syndrome

    NARCIS (Netherlands)

    Eede, F. van den; Moorkens, G.; Hulstijn, W.; Houdenhove, B. van; Cosyns, P.; Claes, S.J.

    2008-01-01

    Background Studies of hypothalamic–pituitary–adrenal (HPA) axis function in chronic fatigue syndrome (CFS) point to hypofunction, although there are negative reports. Suggested mechanisms include a reduced hypothalamic or supra-hypothalamic stimulus to the HPA axis and enhanced sensitivity to the ne

  6. Distinct cerebrospinal fluid proteomes differentiate post-treatment lyme disease from chronic fatigue syndrome.

    Directory of Open Access Journals (Sweden)

    Steven E Schutzer

    Full Text Available BACKGROUND: Neurologic Post Treatment Lyme disease (nPTLS and Chronic Fatigue (CFS are syndromes of unknown etiology. They share features of fatigue and cognitive dysfunction, making it difficult to differentiate them. Unresolved is whether nPTLS is a subset of CFS. METHODS AND PRINCIPAL FINDINGS: Pooled cerebrospinal fluid (CSF samples from nPTLS patients, CFS patients, and healthy volunteers were comprehensively analyzed using high-resolution mass spectrometry (MS, coupled with immunoaffinity depletion methods to reduce protein-masking by abundant proteins. Individual patient and healthy control CSF samples were analyzed directly employing a MS-based label-free quantitative proteomics approach. We found that both groups, and individuals within the groups, could be distinguished from each other and normals based on their specific CSF proteins (p<0.01. CFS (n = 43 had 2,783 non-redundant proteins, nPTLS (n = 25 contained 2,768 proteins, and healthy normals had 2,630 proteins. Preliminary pathway analysis demonstrated that the data could be useful for hypothesis generation on the pathogenetic mechanisms underlying these two related syndromes. CONCLUSIONS: nPTLS and CFS have distinguishing CSF protein complements. Each condition has a number of CSF proteins that can be useful in providing candidates for future validation studies and insights on the respective mechanisms of pathogenesis. Distinguishing nPTLS and CFS permits more focused study of each condition, and can lead to novel diagnostics and therapeutic interventions.

  7. Prevalence of chronic fatigue syndrome in metropolitan, urban, and rural Georgia

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    Boneva Roumiana S

    2007-06-01

    Full Text Available Abstract Background Chronic fatigue syndrome (CFS is a debilitating illness with no known cause or effective therapy. Population-based epidemiologic data on CFS prevalence are critical to put CFS in a realistic context for public health officials and others responsible for allocating resources. Methods Based on a random-digit dialing survey we ascertained CFS cases and controls to estimate the prevalence of CFS in metropolitan, urban, and rural populations of Georgia. This report focuses on the 5,623 of 19,381 respondents ages 18 to 59 years old. Fatigued (2,438, randomly selected unwell not fatigued (1,429 and randomly selected well (1,756 respondents completed telephone questionnaires concerning fatigue, other symptoms, and medical history. Subsets of those identified by interview as having CFS-like illness (292, chronic unwellness which was not CFS-like (268 – randomly selected, and well subjects (223, matched to those with CFS-like illness on sex, race, and age completed a clinical evaluation. Results We estimated that 2.54% of persons 18 to 59 years of age suffered from CFS. There were no significant differences in prevalence of CFS between metropolitan, urban or rural populations or between white and black residents of the three regions. However, there were significant differences in female-to-male ratios of prevalence across the strata (metropolitan female: male 11.2 : 1, urban 1.7 : 1, rural 0.8 : 1. Conclusion We estimated that 2.54% of the Georgia population suffers from CFS, which is 6- to 10-fold higher than previous population-based estimates in other geographic areas. These differences may reflect broader screening criteria and differences in the application of the case definition. However, we cannot exclude the possibility that CFS prevalence may be higher in Georgia than other areas where it has been measured. Although the study did not identify differences in overall prevalence between metropolitan, urban, and rural Georgia

  8. Electroencephalogram characteristics in patients with chronic fatigue syndrome

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    Wu T

    2016-01-01

    Full Text Available Tong Wu,1 Xianghua Qi,1 Yuan Su,2 Jing Teng,1 Xiangqing Xu11Internal Medicine-Neurology, Shandong Provincial Traditional Chinese Medical Hospital, 2School of Mathematic and Quantitative Economics, Shandong University of Finance and Economics, Jinan, People’s Republic of ChinaObjective: To explore the electroencephalogram (EEG characteristics in patients with chronic fatigue syndrome (CFS using brain electrical activity mapping (BEAM and EEG nonlinear dynamical analysis.Methods: Forty-seven outpatients were selected over a 3-month period and divided into an observation group (24 outpatients and a control group (23 outpatients by using the non-probability sampling method. All the patients were given a routine EEG. The BEAM and the correlation dimension changes were analyzed to characterize the EEG features.Results: 1 BEAM results indicated that the energy values of δ, θ, and α1 waves significantly increased in the observation group, compared with the control group (P<0.05, P<0.01, respectively, which suggests that the brain electrical activities in CFS patients were significantly reduced and stayed in an inhibitory state; 2 the increase of δ, θ, and α1 energy values in the right frontal and left occipital regions was more significant than other encephalic regions in CFS patients, indicating the region-specific encephalic distribution; 3 the correlation dimension in the observation group was significantly lower than the control group, suggesting decreased EEG complexity in CFS patients.Conclusion: The spontaneous brain electrical activities in CFS patients were significantly reduced. The abnormal changes in the cerebral functions were localized at the right frontal and left occipital regions in CFS patients.Keywords: electrical activities, brain electrical activity mapping, nonlinear dynamical analysis

  9. Chronic fatigue syndrome

    Science.gov (United States)

    ... fever Medicines to treat anxiety (anti-anxiety drugs) Medicines to treat depression (antidepressant drugs) Some drugs can cause reactions or side effects that are worse than the original symptoms of the disease. People with CFS are encouraged to maintain an ...

  10. Failure to Confirm XMRV/MLVs in the Blood of Patients with Chronic Fatigue Syndrome: A Multi-laboratory Study

    OpenAIRE

    Simmons, Graham; Glynn, Simone A.; Komaroff, Anthony L.; Mikovits, Judy A; Tobler, Leslie H.; Hackett, John; Tang, Ning; Switzer, William M; Heneine, Walid; Hewlett, Indira K; Zhao, Jiangqin; Lo, Shyh-Ching; Alter, Harvey J.; Linnen, Jeffrey M.; Gao, Kui

    2011-01-01

    Murine leukemia viruses (MLV), including xenotropic-MLV-related virus (XMRV), have been controversially linked to chronic fatigue syndrome (CFS). To explore this issue in greater depth, we compiled coded replicate samples of blood from 15 subjects previously reported to be XMRV/MLV-positive (14 with CFS) and from 15 healthy donors previously determined to be negative for the viruses. These samples were distributed in a blinded fashion to nine laboratories which performed assays designed to de...

  11. Use of medications by people with chronic fatigue syndrome and healthy persons: a population-based study of fatiguing illness in Georgia

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    Jones James F

    2009-07-01

    Full Text Available Abstract Background Chronic fatigue syndrome (CFS is a debilitating condition of unknown etiology and no definitive pharmacotherapy. Patients are usually prescribed symptomatic treatment or self-medicate. We evaluated prescription and non-prescription drug use among persons with CFS in Georgia and compared it to that in non-fatigued Well controls and also to chronically Unwell individuals not fully meeting criteria for CFS. Methods A population-based, case-control study. To identify persons with possible CFS-like illness and controls, we conducted a random-digit dialing telephone screening of 19,807 Georgia residents, followed by a detailed telephone interview of 5,630 to identify subjects with CFS-like illness, other chronically Unwell, and Well subjects. All those with CFS-like illness (n = 469, a random sample of chronically Unwell subjects (n = 505, and Well individuals (n = 641 who were age-, sex-, race-, and geographically matched to those with CFS-like illness were invited for a clinical evaluation and 783 participated (48% overall response rate. Clinical evaluation identified 113 persons with CFS, 264 Unwell subjects with insufficient symptoms for CFS (named ISF, and 124 Well controls; the remaining 280 subjects had exclusionary medical or psychiatric conditions, and 2 subjects could not be classified. Subjects were asked to bring all medications taken in the past 2 weeks to the clinic where a research nurse viewed and recorded the name and the dose of each medication. Results More than 90% of persons with CFS used at least one drug or supplement within the preceding two weeks. Among users, people with CFS used an average of 5.8 drugs or supplements, compared to 4.1 by ISF and 3.7 by Well controls. Persons with CFS were significantly more likely to use antidepressants, sedatives, muscle relaxants, and anti-acids than either Well controls or the ISF group. In addition, persons with CFS were significantly more likely to use pain

  12. Fatigue in primary Sjogren's syndrome

    NARCIS (Netherlands)

    P.J. Barendregt (Pieternella); M.R. Visser (Mechteld); E.M.A. Smets (Ellen); J.H.M. Tulen (Joke); A.H. van den Meiracker (Anton); F. Boomsma (Frans); H.M. Markusse

    1998-01-01

    textabstractOBJECTIVE: To assess fatigue in relation to depression, blood pressure, and plasma catecholamines in patients with primary Sjogren's syndrome (SS), in comparison with healthy controls and patients with rheumatoid arthritis. METHODS: For the assessment of fat

  13. Frequency and content analysis of chronic fatigue syndrome in medical text books.

    Science.gov (United States)

    Jason, Leonard A; Paavola, Erin; Porter, Nicole; Morello, Morgan L

    2010-01-01

    Text books are a cornerstone in the training of medical staff and students, and they are an important source of references and reviews for these professionals. The objective of this study was to determine both the quantity and quality of chronic fatigue syndrome (CFS) information included in medical texts. After reviewing 119 medical text books from various medical specialties, we found that 48 (40.3%) of the medical text books included information on CFS. However, among the 129 527 total pages within these medical text books, the CFS content was presented on only 116.3 (0.090%) pages. Other illnesses that are less prevalent, such as multiple sclerosis and Lyme disease, were more frequently represented in medical text books. These findings suggest that the topic ofCFS is underreported in published medical text books.

  14. Effects of qigong exercise on fatigue, anxiety, and depressive symptoms of patients with chronic fatigue syndrome-like illness: a randomized controlled trial.

    Science.gov (United States)

    Chan, Jessie S M; Ho, Rainbow T H; Wang, Chong-Wen; Yuen, Lai Ping; Sham, Jonathan S T; Chan, Cecilia L W

    2013-01-01

    Background. Anxiety/depressive symptoms are common in patients with chronic fatigue syndrome- (CFS-) like illness. Qigong as a modality of complementary and alternative therapy has been increasingly applied by patients with chronic illnesses, but little is known about the effect of Qigong on anxiety/depressive symptoms of the patients with CFS-like illness. Purpose. To investigate the effects of Qigong on fatigue, anxiety, and depressive symptoms in patients with CFS-illness. Methods. One hundred and thirty-seven participants who met the diagnostic criteria for CFS-like illness were randomly assigned to either an intervention group or a waitlist control group. Participants in the intervention group received 10 sessions of Qigong training twice a week for 5 consecutive weeks, followed by home-based practice for 12 weeks. Fatigue, anxiety, and depressive symptoms were assessed at baseline and postintervention. Results. Total fatigue score [F(1,135) = 13.888, P Qigong group compared to controls. The anxiety score was not significantly improved in the Qigong group. Conclusion. Qigong may not only reduce the fatigue symptoms, but also has antidepressive effect for patients with CFS-like illness. Trial registration HKCTR-1200.

  15. Diagnosing chronic fatigue syndrome in south asians: Lessons from a secondary analysis of a UK qualitative study

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    R Erandie Ediriweera De Silva

    2013-01-01

    Full Text Available Background: Chronic fatigue syndrome/myalgic encephalitis (CFS/ME is rarely diagnosed in South Asia (SA, although the symptoms of this condition are seen in the population. Lessons from UK based South Asian, Black and Minority Ethnic (BME communities may be of value in identifying barriers to diagnosis of CFS/ME in SA. Objectives: To explore why CFS/ME may not be commonly diagnosed in SA. Settings and Design: A secondary analysis of qualitative data on the diagnosis and management of CFS/ME in BME people of predominantly South Asian origin in the UK using 27 semi-structured qualitative interviews with people with CFE/ME, carers, general practitioners (GPs, and community leaders. Results: CFS/ME is seen among the BME communities in the UK. People from BME communities in the UK can present to healthcare practitioners with vague physical complaints and they can hold a biomedical model of illness. Patients found it useful to have a label of CFS/ME although some GPs felt it to be a negative label. Access to healthcare can be limited by GPs reluctance to diagnose CFS/ME, their lack of knowledge and patients negative experiences. Cultural aspects among BME patients in the UK also act as a barrier to the diagnosis of CFS/ME. Conclusion: Cultural values and practices influence the diagnosis of CFS/ME in BME communities. The variations in the perceptions around CFS/ME among patients, carers, and health professionals may pose challenges in diagnosing CFS/ME in SA as well. Raising awareness of CFS/ME would improve the diagnosis and management of patients with CFS/ME in SA.

  16. Subset-directed antiviral treatment of 142 herpesvirus patients with chronic fatigue syndrome

    Directory of Open Access Journals (Sweden)

    A Martin Lerner

    2010-05-01

    Full Text Available A Martin Lerner1, Safedin Beqaj2, James T Fitzgerald3, Ken Gill4, Carol Gill4, James Edington41Department of Medicine, William Beaumont Hospital, Royal Oak; 2Wayne State University School of Medicine, Detroit; 3Department of Medical Education, University of Michigan Medical School, Ann Arbor, Michigan; 4The Dr A Martin Lerner Chronic Fatigue Syndrome Foundation, Beverly Hills, Michigan, USAPurpose: We hypothesized that chronic fatigue syndrome (CFS may be caused by single or multiple Epstein–Barr virus (EBV, cytomegalovirus (HCMV, or human herpesvirus 6 (HHV6 infection. To determine if CFS life-altering fatigue and associated findings including muscle aches, tachycardia at rest, chest aches, left ventricular dysfunction, syncope, and elevated herpesvirus serum antibody titers are reversed by long-term subset-directed valacyclovir and/or valganciclovir.Patients and methods: Data were collected at physician visits every 4–6 weeks from 142 CFS patients at one clinic from 2001 to 2007. To be included in this study, patients had to be followed for at least six months. The data captured included over 7000 patient visits and over 35,000 fields of information. Severity of fatigue was monitored by a validated Energy Index Point Score® (EIPS®. Baseline and follow-up serum antibody titers to EBV, HCMV, and HHV6, as well as coinfections with Borrelia burgdorferi, Anaplasma phagocytophila, Babesia microti, and antistreptolysin O, 24-hour ECG Holter monitors, 2D echocardiograms, cardiac dynamic studies, symptoms, and toxicity were captured and monitored. International criteria for CFS plus a specifically designed CFS diagnostic panel were used.Results and conclusions: The Group A herpesvirus CFS patients (no coinfections returned to a near-normal to normal life (P = 0.0001. The long-term EIPS value increased (primary endpoint, P < 0.0001 with subset-directed long-term valacyclovir and/or valganciclovir therapy. Secondary endpoints (cardiac, immunologic

  17. The association between borderline personality disorder, fibromyalgia and chronic fatigue syndrome: systematic review

    Science.gov (United States)

    Penfold, Sarah; St. Denis, Emily

    2016-01-01

    Background Overlap of aetiological factors and demographic characteristics with clinical observations of comorbidity has been documented in fibromyalgia syndrome, chronic fatigue syndrome (CFS) and borderline personality disorder (BPD). Aims The purpose of this study was to assess the association of BPD with fibromyalgia syndrome and CFS. The authors reviewed literature on the prevalence of BPD in patients with fibromyalgia or CFS and vice versa. Methods A search of five databases yielded six eligible studies. A hand search and contact with experts yielded two additional studies. We extracted information pertaining to study setting and design, demographic information, diagnostic criteria and prevalence. Results We did not identify any studies that specifically assessed the prevalence of fibromyalgia or CFS in patients with BPD. Three studies assessed the prevalence of BPD in fibromyalgia patients and reported prevalence of 1.0, 5.25 and 16.7%. Five studies assessed BPD in CFS patients and reported prevalence of 3.03, 1.8, 2.0, 6.5 and 17%. Conclusions More research is required to clarify possible associations between BPD, fibromyalgia and CFS. Declaration of interest None. Copyright and usage © The Royal College of Psychiatrists 2016. This is an open access article distributed under the terms of the Creative Commons Non-Commercial, No Derivatives (CC BY-NC-ND) license. PMID:27703787

  18. A pilot study employing Dehydroepiandrosterone (DHEA) in the treatment of chronic fatigue syndrome.

    Science.gov (United States)

    Himmel, P B; Seligman, T M

    1999-04-01

    Patients with chronic fatigue syndrome (CFS) frequently associate the disease onset with a period of high physical and/or emotional stress. Alterations in hypothalamic-pituitary adrenal axis (HPA) function have been demonstrated. Although Cortisol production in patients with CFS has proven to be low, Dehydroepiandrosterone (DHEA) production has not been measured. DHEA output may be altered in this population. The purpose of this uncontrolled, prospective, 6 month study of 23 white women, ages 35-55 was to identify CFS patients with suboptimal serum levels of DHEA-sulphate (DHEA-S), defined as DHEA-S DHEA. DHEA-S levels were re-measured after 4-6 weeks of oral DHEA therapy (25 mg). If DHEA-S remained DHEA was given. Physical and psychological impairment and disability status were measured by the MHAQII before DHEA intervention and at 3-month intervals. Of initially screened patients with CFS, 76% (116 of 153) were ages 35-55, and 89% (103 of 116) had suboptimal (DHEA-S.Supplementation with DHEA to CFS patients lead to a significant reduction in the symptoms of CFS: pain (improved by 18%, p = 0.035), fatigue (decreased by 21%, p = 0.009)), activities of daily living (improved by 8.5%, p = 0.058), helplessness (decreased by 11%, p = 0.015), anxiety (decreased by 35%, p memory (improved by 17%, p DHEA to this population in a controlled setting.

  19. Birth order and its association with the onset of chronic fatigue syndrome.

    Science.gov (United States)

    Brimacombe, Michael; Helmer, Drew A; Natelson, Benjamin H

    2002-08-01

    Chronic fatigue syndrome (CFS) is a medically unexplained illness that is diagnosed on the basis of a clinical case definition; so it probably is an illness with multiple causes producing the same clinical picture. One way of dealing with this heterogeneity is to stratify patients based on illness onset. We hypothesized that either the whole group of CFS patients or that group which developed CFS gradually would show a relation with birth order, while patients who developed CFS suddenly, probably due to a viral illness, would not show such a relation. We hypothesized the birth order effect in the gradual onset group because those patients have more psychological problems, and birth order effects have been shown for psychological characteristics. We compared birth order in our CFS patients to that in a comparison group derived from U.S. demographic data. We found a tendency that did not reach formal statistical significance for a birth order effect in the gradual onset group, but not in either the sudden onset or combined total group. However, the birth order effect we found was due to relatively increased rates of CFS in second-born children; prior birth order studies of personality characteristics have found such effects to be skewed toward first-born children. Thus, our data do support a birth order effect in a subset of patients with CFS. The results of this study should encourage a larger multicenter study to further explore and understand this relation.

  20. Timed loaded standing in female chronic fatigue syndrome compared with other populations

    Directory of Open Access Journals (Sweden)

    Jan b Eyskens, MSc PT, DO, Pr Ph

    2015-04-01

    Full Text Available Patients with chronic fatigue syndrome (CFS, like patients with osteoporosis, have similar difficulties in standing and sitting. The aim of the study was to compare combined trunk and arm endurance among women with CFS (n = 72, women with osteoporosis (n = 30, nondisabled women (n = 55, and women from non-industrialized countries (n = 58 using the timed loaded standing (TLS test. TLS measures how long a person can hold a 1 kg dumbbell in each hand in front of him or her with straight arms. TLS was higher in the industrialized nondisabled population than in the non-industrialized study population (p < 0.001 and in patients with osteoporosis (p = 0.002. TLS was lower in patients with CFS than in nondisabled controls (p < 0.001. After adjusting for age, body height, and weight, combined trunk and arm endurance was even lower in CFS than in osteoporotic patients more than 25 yr old (p < 0.001. In CFS, TLS was lower than in the non-industrialized group (p = 0.02. Since only women were studied, external validity of the results is limited to adult female patients with CFS. TLS revealed a specific biomechanical weakness in CFS patients that can be taken into account from the onset of a rehabilitation program. We propose that influencing the quality, rather than the quantity, of movement could be used in the rehabilitation.

  1. Gross and fine motor function in fibromyalgia and chronic fatigue syndrome

    Science.gov (United States)

    Rasouli, Omid; Fors, Egil A; Borchgrevink, Petter Chr; Öhberg, Fredrik; Stensdotter, Ann-Katrin

    2017-01-01

    Purpose This paper aimed to investigate motor proficiency in fine and gross motor function, with a focus on reaction time (RT) and movement skill, in patients with fibromyalgia (FM) and chronic fatigue syndrome (CFS) compared to healthy controls (HC). Methods A total of 60 individuals (20 CFS, 20 FM, and 20 HC), age 19–49 years, participated in this study. Gross motor function in the lower extremity was assessed using a RT task during gait initiation in response to an auditory trigger. Fine motor function in the upper extremity was measured during a precision task (the Purdue Pegboard test) where the number of pins inserted within 30 s was counted. Results No significant differences were found between FM and CFS in any parameters. FM and CFS groups had significantly longer RT than HC in the gait initiation (p=0.001, and p=0.004 respectively). In the Purdue Pegboard test, 20% in the FM group, 15% in the CFS groups, and 0% of HC group, scored below the threshold of the accepted performance. However, there were no significant differences between FM, CFS, and HC in this task (p=0.12). Conclusion Compared to controls, both CFS and FM groups displayed significantly longer RT in the gait initiation task. Generally, FM patients showed the worst results in both tests, although no group differences were found in fine motor control, according to the Purdue Pegboard test. PMID:28223840

  2. Immunomodulating and antioxidant effects of polysaccharide conjugates from the fruits of Ziziphus Jujube on Chronic Fatigue Syndrome rats.

    Science.gov (United States)

    Chi, Aiping; Kang, Chenzhe; Zhang, Yan; Tang, Liang; Guo, Huanhuan; Li, Hong; Zhang, Kunru

    2015-05-20

    To detect the treatment effect of the fruits of Ziziphus Jujube in Chronic Fatigue Syndrome (CFS). Jujube polysaccharide conjugates (JPC) were isolated from the fruits of Z. Jujube. General physicochemical properties of JPC were analyzed. A four-week rats CFS model was established and JPC were orally administrated, the behavior experiments were conducted after CFS. The activities of superoxide dismutase (SOD), glutathione peroxidase (GSH-Px), and the levels of malondialdehyde (MDA) in serum were elevated and T lymphocyte proliferation, CD4(+)/CD8(+) ratio and natural killer (NK) cells activity were analyzed. JPC markedly improved behaviors of CFS rats, also decreased MDA levels in serum, and elevated T lymphocyte proliferation, CD4(+)/CD8(+) ratio and natural killer (NK) cells activities. This suggests that JPC can improve the immune system and antioxidant activity of CFS rats and might be regarded as a biological response modifier. Copyright © 2015 Elsevier Ltd. All rights reserved.

  3. Mitochondrial Myopathy in Follow-up of a Patient With Chronic Fatigue Syndrome

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    Fernando Galán AOPT

    2015-09-01

    Full Text Available Introduction. Symptoms of mitochondrial diseases and chronic fatigue syndrome (CFS frequently overlap and can easily be mistaken. Methods. We report the case of a patient diagnosed with CFS and during follow-up was finally diagnosed with mitochondrial myopathy by histochemical study of muscle biopsy, spectrophotometric analysis of the complexes of the mitochondrial respiratory chain, and genetic studies. Results. The results revealed 3% fiber-ragged blue and a severe deficiency of complexes I and IV and several mtDNA variants. Mother, sisters, and nephews showed similar symptoms, which strongly suggests a possible maternal inheritance. The patient and his family responded to treatment with high doses of riboflavin and thiamine with a remarkable and sustained fatigue and muscle symptoms improvement. Conclusions. This case illustrates that initial symptoms of mitochondrial disease in adults can easily be mistaken with CFS, and in these patients a regular reassessment and monitoring of symptoms is recommended to reconfirm or change the diagnosis.

  4. Caught in the thickness of brain fog: exploring the cognitive symptoms of Chronic Fatigue Syndrome

    Directory of Open Access Journals (Sweden)

    Anthony James Ocon

    2013-04-01

    Full Text Available Chronic Fatigue Syndrome (CFS is defined as greater than 6 months of persistent fatigue that is experienced physically and cognitively. The cognitive symptoms are generally thought to be a mild cognitive impairment, but individuals with CFS subjectively describe them as brain fog. The impairment is not fully understood and often is described as slow thinking, difficulty focusing, confusion, lack of concentration, forgetfulness, or a haziness in thought processes. Causes of brain fog and mild cognitive impairment have been investigated. Possible physiological correlates may be due to the effects of chronic orthostatic intolerance in the form of the Postural Tachycardia Syndrome and decreases in cerebral blood flow. In addition, fMRI studies suggest that individuals with CFS may require increased cortical and subcortical brain activation to complete difficult mental tasks. Furthermore, neurocognitive testing in CFS has demonstrated deficits in speed and efficiency of information processing, attention, concentration, and working memory. The cognitive impairments are then perceived as an exaggerated mental fatigue. As a whole, this is experienced by those with CFS as brain fog and may be viewed as the interaction of physiological, cognitive, and perceptual factors. Thus, the cognitive symptoms of CFS may be due to altered cerebral blood flow activation and regulation that are exacerbated by a stressor, such as orthostasis or a difficult mental task, resulting in the decreased ability to readily process information, which is then perceived as fatiguing and experienced as brain fog. Future research looks to further explore these interactions, how they produce cognitive impairments, and explain the perception of brain fog from a mechanistic standpoint.

  5. Exercise therapy for chronic fatigue syndrome.

    Science.gov (United States)

    Larun, Lillebeth; Brurberg, Kjetil G; Odgaard-Jensen, Jan; Price, Jonathan R

    2017-04-25

    Chronic fatigue syndrome (CFS) is characterised by persistent, medically unexplained fatigue, as well as symptoms such as musculoskeletal pain, sleep disturbance, headaches and impaired concentration and short-term memory. CFS presents as a common, debilitating and serious health problem. Treatment may include physical interventions, such as exercise therapy, which was last reviewed in 2004. The objective of this review was to determine the effects of exercise therapy (ET) for patients with CFS as compared with any other intervention or control.• Exercise therapy versus 'passive control' (e.g. treatment as usual, waiting-list control, relaxation, flexibility).• Exercise therapy versus other active treatment (e.g. cognitive-behavioural therapy (CBT), cognitive treatment, supportive therapy, pacing, pharmacological therapy such as antidepressants).• Exercise therapy in combination with other specified treatment strategies versus other specified treatment strategies (e.g. exercise combined with pharmacological treatment vs pharmacological treatment alone). We searched The Cochrane Collaboration Depression, Anxiety and Neurosis Controlled Trials Register (CCDANCTR), the Cochrane Central Register of Controlled Trials (CENTRAL) and SPORTDiscus up to May 2014 using a comprehensive list of free-text terms for CFS and exercise. We located unpublished or ongoing trials through the World Health Organization (WHO) International Clinical Trials Registry Platform (to May 2014). We screened reference lists of retrieved articles and contacted experts in the field for additional studies SELECTION CRITERIA: Randomised controlled trials involving adults with a primary diagnosis of CFS who were able to participate in exercise therapy. Studies had to compare exercise therapy with passive control, psychological therapies, adaptive pacing therapy or pharmacological therapy. Two review authors independently performed study selection, risk of bias assessments and data extraction. We

  6. Gene expression profile exploration of a large dataset on chronic fatigue syndrome.

    Science.gov (United States)

    Fang, Hong; Xie, Qian; Boneva, Roumiana; Fostel, Jennifer; Perkins, Roger; Tong, Weida

    2006-04-01

    To gain understanding of the molecular basis of chronic fatigue syndrome (CFS) through gene expression analysis using a large microarray data set in conjunction with clinically administrated questionnaires. Data from the Wichita (KS, USA) CFS Surveillance Study was used, comprising 167 participants with two self-report questionnaires (multidimensional fatigue inventory [MFI] and Zung depression scale [Zung]), microarray data, empiric classification, and others. Microarray data was analyzed using bioinformatics tools from ArrayTrack. Correspondence analysis was applied to the MFI questionnaire to select the 23 samples having either the most or the least fatigue, and to the Zung questionnaire to select the 26 samples having either the most or least depression; ten samples were common, resulting in a total of 39 samples. The MFI and Zung-based CFS/non-CFS (NF) classifications on the 39 samples were consistent with the empiric classification. Two differentially-expressed gene lists were determined, 188 fatigue-related genes and 164 depression-related genes, which shared 24 common genes and involved 11 common pathways. Principal component analysis based on 24 genes clearly separates 39 samples with respect to their likelihood to be CFS. Most of the 24 genes are not previously reported for CFS, yet their functions are consistent with the prevailing model of CFS, such as immune response, apoptosis, ion channel activity, signal transduction, cell-cell signaling, regulation of cell growth and neuronal activity. Hierarchical cluster analysis was performed based on 24 genes to classify 128 (=167-39) unassigned samples. Several of the 11 identified common pathways are supported by earlier findings for CFS, such as cytokine-cytokine receptor interaction and neuroactive ligand-receptor interaction. Importantly, most of the 11 common pathways are interrelated, suggesting complex biological mechanisms associated with CFS. Bioinformatics is critical in this study to select

  7. Autonomic correlations with MRI are abnormal in the brainstem vasomotor centre in Chronic Fatigue Syndrome

    Science.gov (United States)

    Barnden, Leighton R.; Kwiatek, Richard; Crouch, Benjamin; Burnet, Richard; Del Fante, Peter

    2016-01-01

    Autonomic changes are often associated with the chronic fatigue syndrome (CFS), but their pathogenetic role is unclear and brain imaging investigations are lacking. The vasomotor centre and, through it, nuclei in the midbrain and hypothalamus play a key role in autonomic nervous system regulation of steady state blood pressure (BP) and heart rate (HR). In this exploratory cross-sectional study, BP and HR, as indicators of autonomic function, were correlated with volumetric and T1- and T2-weighted spin-echo (T1w and T2w) brain MRI in 25 CFS subjects and 25 normal controls (NC). Steady state BP (systolic, diastolic and pulse pressure) and HR in two postures were extracted from 24 h blood pressure monitoring. We performed (1) MRI versus autonomic score interaction-with-group regressions to detect locations where regression slopes differed in the CFS and NC groups (collectively indicating abnormality in CFS), and (2) MRI regressions in the CFS and NC groups alone to detect additional locations with abnormal correlations in CFS. Significant CFS regressions were repeated controlling for anxiety and depression (A&D). Abnormal regressions were detected in nuclei of the brainstem vasomotor centre, midbrain reticular formation and hypothalamus, but also in limbic nuclei involved in stress responses and in prefrontal white matter. Group comparisons of CFS and NC did not find MRI differences in these locations. We propose therefore that these regulatory nuclei are functioning correctly, but that two-way communication between them is impaired in CFS and this affects signalling to/from peripheral effectors/sensors, culminating in inverted or magnified correlations. This single explanation for the diverse abnormal correlations detected here consolidates the conclusion for a brainstem/midbrain nerve conduction deficit inferred earlier (Barnden et al., 2015). Strong correlations were also detected in isolated NC regressions. PMID:27114901

  8. Psychosocial factors involved in memory and cognitive failures in people with myalgic encephalomyelitis/chronic fatigue syndrome

    Directory of Open Access Journals (Sweden)

    Attree EA

    2014-02-01

    Full Text Available Elizabeth A Attree,1 Megan A Arroll,1 Christine P Dancey,1 Charlene Griffith,1 Amolak S Bansal1,2 1Chronic Illness Research Team, School of Psychology, University of East London, London, UK; 2Department of Immunology and the Sutton CFS Service, St Helier Hospital, Carshalton, UK Background: Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS is characterized by persistent emotional, mental, and physical fatigue accompanied by a range of neurological, autonomic, neuroendocrine, immune, and sleep problems. Research has shown that psychosocial factors such as anxiety and depression as well as the symptoms of the illness, have a significant impact on the quality of life of people with ME/CFS. In addition, individuals may suffer from deficits in memory and concentration. This study set out to explore the relationships between variables which have been found to contribute to cognitive performance, as measured by prospective and retrospective memory, and cognitive failures. Methods: Eighty-seven people with ME/CFS answered questionnaires measuring fatigue, depression, anxiety, social support, and general self-efficacy. These were used in a correlational design (multiple regression to predict cognitive function (self-ratings on prospective and retrospective memory, and cognitive failures. Results: Our study found that fatigue, depression, and general self-efficacy were directly associated with cognitive failures and retrospective (but not prospective memory. Conclusion: Although it was not possible in this study to determine the cause of the deficits, the literature in this area leads us to suggest that although the pathophysiological mechanisms of ME/CFS are unclear, abnormalities in the immune system, including proinflammatory cytokines, can lead to significant impairments in cognition. We suggest that fatigue and depression may be a result of the neurobiological effects of ME/CFS and in addition, that the neurobiological effects of the illness

  9. Sleep assessment in a population-based study of chronic fatigue syndrome

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    Reyes Michele

    2004-04-01

    Full Text Available Abstract Background Chronic fatigue syndrome (CFS is a disabling condition that affects approximately 800,000 adult Americans. The pathophysiology remains unknown and there are no diagnostic markers or characteristic physical signs or laboratory abnormalities. Most CFS patients complain of unrefreshing sleep and many of the postulated etiologies of CFS affect sleep. Conversely, many sleep disorders present similarly to CFS. Few studies characterizing sleep in unselected CFS subjects have been published and none have been performed in cases identified from population-based studies. Methods The study included 339 subjects (mean age 45.8 years, 77% female, 94.1% white identified through telephone screen in a previously described population-based study of CFS in Wichita, Kansas. They completed questionnaires to assess fatigue and wellness and 2 self-administered sleep questionnaires. Scores for five of the six sleep factors (insomnia/hypersomnia, non-restorative sleep, excessive daytime somnolence, sleep apnea, and restlessness in the Centre for Sleep and Chronobiology's Sleep Assessment Questionnaire© (SAQ© were dichotomized based on threshold. The Epworth Sleepiness Scale score was used as a continuous variable. Results 81.4% of subjects had an abnormality in at least one SAQ© sleep factor. Subjects with sleep factor abnormalities had significantly lower wellness scores but statistically unchanged fatigue severity scores compared to those without SAQ© abnormality. CFS subjects had significantly increased risk of abnormal scores in the non-restorative (adjusted odds ratio [OR] = 28.1; 95% confidence interval [CI]= 7.4–107.0 and restlessness (OR = 16.0; 95% CI = 4.2–61.6 SAQ© factors compared to non-fatigued, but not for factors of sleep apnea or excessive daytime somnolence. This is consistent with studies finding that, while fatigued, CFS subjects are not sleepy. A strong correlation (0.78 of Epworth score was found only for the excessive

  10. The economic impact of chronic fatigue syndrome in Georgia: direct and indirect costs

    Directory of Open Access Journals (Sweden)

    Brimmer Dana J

    2011-01-01

    Full Text Available Abstract Background Chronic fatigue syndrome (CFS is a debilitating chronic illness affecting at least 4 million people in the United States. Understanding its cost improves decisions regarding resource allocation that may be directed towards treatment and cure, and guides the evaluation of clinical and community interventions designed to reduce the burden of disease. Methods This research estimated direct and indirect costs of CFS and the impact on educational attainment using a population-based, case-control study between September 2004 and July 2005, Georgia, USA. Participants completed a clinical evaluation to confirm CFS, identify other illnesses, and report on socioeconomic factors. We estimated the effect of CFS on direct medical costs (inpatient hospitalizations, provider visits, prescription medication spending, other medical supplies and services and loss in productivity (employment and earnings with a stratified sample (n = 500 from metropolitan, urban, and rural Georgia. We adjusted medical costs and earnings for confounders (age, sex, race/ethnicity, education, and geographic strata using econometric models and weighted estimates to reflect response-rate adjusted sampling rates. Results Individuals with CFS had mean annual direct medical costs of $5,683. After adjusting for confounding factors, CFS accounted for $3,286 of these costs (p Conclusions Study results indicate that chronic fatigue syndrome may lead to substantial increases in healthcare costs and decreases in individual earnings. Studies have estimated up to 2.5% of non-elderly adults may suffer from CFS. In Georgia, a state with roughly 5.5 million people age 18-59, illness could account for $452 million in total healthcare expenditures and $1.2 billion of lost productivity.

  11. Epidemiological characteristics of chronic fatigue- syndrome/myalgic encephalomyelitis in Australian patients

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    Johnston SC

    2016-05-01

    Full Text Available Samantha C Johnston1,2 Donald R Staines1 Sonya M Marshall-Gradisnik1,2 1National Centre for Neuroimmunology and Emerging Diseases, Menzies Health Institute Queensland, 2School of Medical Sciences, Griffith University, Parklands, QLD, Australia Background: No epidemiological investigations have previously been conducted in Australia according to the current clinical definitions of chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME. The aim of this study was to describe sociodemographic and illness characteristics of Australian patients with CFS/ME.Methods: A cross-sectional survey on the medical history of patients enrolled in an Australian CFS/ME research database between April 2013 and April 2015. Participants were classified according to Fukuda criteria and International Consensus Criteria.Results: A total of 535 patients diagnosed with CFS/ME by a primary care physician were identified. The mean age of all patients was 46.4 years (standard deviation 12.0; the majority were female (78.61%, Caucasian, and highly educated. Of these, 30.28% met Fukuda criteria. A further 31.96% met both Fukuda criteria and International Consensus Criteria. There were 14.58% reporting chronic fatigue but did not meet criteria for CFS/ME and 23.18% were considered noncases due to exclusionary conditions. Within those meeting CFS/ME criteria, the most common events prior to illness included cold or flu, gastrointestinal illness, and periods of undue stress. Of the 60 symptoms surveyed, fatigue, cognitive, and short-term memory symptoms, headaches, muscle and joint pain, unrefreshed sleep, sensory disturbances, muscle weakness, and intolerance to extremes of temperature were the most commonly occurring symptoms (reported by more than two-thirds of patients. Significant differences in symptom occurrence between Fukuda- and International Consensus Criteria-defined cases were also identified.Conclusion: This is the first study to summarize sociodemographic and

  12. The impact of informational interventions about cognitive behavioral therapy for chronic fatigue syndrome on GPs referral behavior.

    NARCIS (Netherlands)

    Scheeres, K.; Wensing, M.J.P.; Mes, C.; Bleijenberg, G.

    2007-01-01

    OBJECTIVE: This study investigated the impact of an informational intervention among general practitioners (GPs) about a new treatment with cognitive behavioral therapy (CBT) for chronic fatigue syndrome (CFS) in a mental health center (MHC). The outcome measures concerned GPs knowledge and attitude

  13. Influence of symptom expectancies on stair-climbing performance in chronic fatigue syndrome: effect of study context.

    NARCIS (Netherlands)

    Heins, M.; Knoop, H.; Nijs, J.; Feskens, R.; Meeus, M.; Moorkens, G.; Bleijenberg, G.

    2013-01-01

    Background: In patients with chronic fatigue syndrome (CFS), performance of physical activities may be affected by an anticipated increase in symptoms after these activities. Nijs et al. previously studied the influence of symptom expectancies and related psychological processes on the performance

  14. Influence of symptom expectancies on stair-climbing performance in chronic fatigue syndrome: effect of study context

    NARCIS (Netherlands)

    Heins, M.; Knoop, H.; Nijs, J.; Feskens, R.C.W.; Meeus, M.; Moorkens, G.; Bleijenberg, G.

    2013-01-01

    BACKGROUND: In patients with chronic fatigue syndrome (CFS), performance of physical activities may be affected by an anticipated increase in symptoms after these activities. Nijs et al. previously studied the influence of symptom expectancies and related psychological processes on the performance

  15. Metabolic profiling indicates impaired pyruvate dehydrogenase function in myalgic encephalopathy/chronic fatigue syndrome.

    Science.gov (United States)

    Fluge, Øystein; Mella, Olav; Bruland, Ove; Risa, Kristin; Dyrstad, Sissel E; Alme, Kine; Rekeland, Ingrid G; Sapkota, Dipak; Røsland, Gro V; Fosså, Alexander; Ktoridou-Valen, Irini; Lunde, Sigrid; Sørland, Kari; Lien, Katarina; Herder, Ingrid; Thürmer, Hanne; Gotaas, Merete E; Baranowska, Katarzyna A; Bohnen, Louis M L J; Schäfer, Christoph; McCann, Adrian; Sommerfelt, Kristian; Helgeland, Lars; Ueland, Per M; Dahl, Olav; Tronstad, Karl J

    2016-12-22

    Myalgic encephalopathy/chronic fatigue syndrome (ME/CFS) is a debilitating disease of unknown etiology, with hallmark symptoms including postexertional malaise and poor recovery. Metabolic dysfunction is a plausible contributing factor. We hypothesized that changes in serum amino acids may disclose specific defects in energy metabolism in ME/CFS. Analysis in 200 ME/CFS patients and 102 healthy individuals showed a specific reduction of amino acids that fuel oxidative metabolism via the TCA cycle, mainly in female ME/CFS patients. Serum 3-methylhistidine, a marker of endogenous protein catabolism, was significantly increased in male patients. The amino acid pattern suggested functional impairment of pyruvate dehydrogenase (PDH), supported by increased mRNA expression of the inhibitory PDH kinases 1, 2, and 4; sirtuin 4; and PPARδ in peripheral blood mononuclear cells from both sexes. Myoblasts grown in presence of serum from patients with severe ME/CFS showed metabolic adaptations, including increased mitochondrial respiration and excessive lactate secretion. The amino acid changes could not be explained by symptom severity, disease duration, age, BMI, or physical activity level among patients. These findings are in agreement with the clinical disease presentation of ME/CFS, with inadequate ATP generation by oxidative phosphorylation and excessive lactate generation upon exertion.

  16. Association between cognitive performance, physical fitness, and physical activity level in women with chronic fatigue syndrome

    Directory of Open Access Journals (Sweden)

    Kelly Ickmans, PT, MSc

    2013-08-01

    Full Text Available Limited scientific evidence suggests that physical activity is directly related to cognitive performance in patients with chronic fatigue syndrome (CFS. To date, no other study has examined the direct relationship between cognitive performance and physical fitness in these patients. This study examined whether cognitive performance and physical fitness are associated in female patients with CFS and investigated the association between cognitive performance and physical activity level (PAL in the same study sample. We hypothesized that patients who performed better on cognitive tasks would show increased PALs and better performance on physical tests. The study included 31 women with CFS and 13 healthy inactive women. Participants first completed three cognitive tests. Afterward, they undertook a test to determine their maximal handgrip strength, performed a bicycle ergometer test, and were provided with an activity monitor. In patients with CFS, lower peak oxygen uptake and peak heart rate were associated with slower psychomotor speed (p < 0.05. Maximal handgrip strength was correlated with working memory performance (p < 0.05. Both choice and simple reaction time were lower in patients with CFS relative to healthy controls (p < 0.05 and p < 0.001, respectively. In conclusion, physical fitness, but not PAL, is associated with cognitive performance in female patients with CFS.

  17. Clinical Observation on the Effects of Bo's Abdominal Acupuncture in 40 Cases of Chronic Fatigue Syndrome

    Institute of Scientific and Technical Information of China (English)

    HUANG Yong; LIAO Xiao-ming; LI xiao-xi; SONG Yuan-bin

    2008-01-01

    objective;To observe the curative effect of Bo's abdominal acupuncture on chronic fatigue syndrome(CFS).Methods;Forty cases with CFS were treated by Bo's abdominal acupuncture at me points for conducting qi back to its origin and 4 points on the abdomen once a dav for 2 weeks.Scores for symptoms and scores for fatigue questionnaires were compared before and after treatment.Results;After treatment,the clinical symptoms of patients were differently alleviated,and scores for symptoms,mental condition and neural feeling in questionnaires on fatigue were obviously reduced(P<0.01-0.05).Conclusion;Bo's abdominal acupuncture has a good curative effect on general disease with complex symptoms,especially on lassitude,anorlexia,insomnia,amnesia,diarrhea,and general pain.

  18. Neurohumoral and haemodynamic profile in postural tachycardia and chronic fatigue syndromes

    Science.gov (United States)

    Okamoto, Luis E.; Raj, Satish R.; Peltier, Amanda; Gamboa, Alfredo; Shibao, Cyndya; Diedrich, André; Black, Bonnie K.; Robertson, David; Biaggioni, Italo

    2011-01-01

    Several studies recognized an overlap between CFS (chronic fatigue syndrome) and POTS (postural tachycardia syndrome). We compared the autonomic and neurohormonal phenotype of POTS patients with CFS (CFS–POTS) to those without CFS (non-CFS–POTS), to determine whether CFS–POTS represents a unique clinical entity with a distinct pathophysiology. We recruited 58 patients with POTS, of which 47 were eligible to participate. A total of 93% of them reported severe fatigue [CIS (Checklist of Individual Strength), fatigue subscale >36], and 64% (n=30) fulfilled criteria for CFS (CFS–POTS). The prevalence of CFS symptoms (Centers for Disease Control and Prevention criteria) was greater in the CFS–POTS group, but the pattern of symptoms was similar in both groups. Physical functioning was low in both groups (RAND-36 Health Survey, 40±4 compared with 33±3; P=0.153), despite more severe fatigue in CFS–POTS patients (CIS fatigue subscale 51±1 compared with 43±3; P=0.016). CFS–POTS patients had greater orthostatic tachycardia than the non-CFS–POTS group (51±3 compared with 40±4 beats/min; P=0.030), greater low-frequency variability of BP (blood pressure; 6.3±0.7 compared with 4.8±1.0 mmHg2; P=0.019), greater BP recovery from early to late phase II of the Valsalva manoeuvre (18±3 compared with 11±2 mmHg; P=0.041) and a higher supine (1.5±0.2 compared with 1.0±0.3 ng/ml per·h; P=0.033) and upright (5.4±0.6 compared with 3.5±0.8 ng/ml per h; P=0.032) PRA (plasma renin activity). In conclusion, fatigue and CFS-defining symptoms are common in POTS patients. The majority of them met criteria for CFS. CFS–POTS patients have higher markers of sympathetic activation, but are part of the spectrum of POTS. Targeting this sympathetic activation should be considered in the treatment of these patients. PMID:21906029

  19. Chronic fatigue syndrome after Giardia enteritis: clinical characteristics, disability and long-term sickness absence

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    Naess Halvor

    2012-02-01

    Full Text Available Abstract Background A waterborne outbreak of Giardia lamblia gastroenteritis led to a high prevalance of long-lasting fatigue and abdominal symptoms. The aim was to describe the clinical characteristics, disability and employmentloss in a case series of patients with Chronic Fatigue Syndrome (CFS after the infection. Methods Patients who reported persistent fatigue, lowered functional capacity and sickness leave or delayed education after a large community outbreak of giardiasis enteritis in the city of Bergen, Norway were evaluated with the established Centers for Disease Control and Prevention criteria for CFS. Fatigue was self-rated by the Fatigue Severity Scale (FSS. Physical and mental health status and functional impairment was measured by the Medical Outcome Severity Scale-short Form-36 (SF-36. The Hospital Anxiety and Depression Scale (HADS was used to measure co-morbid anxiety and depression. Inability to work or study because of fatigue was determined by sickness absence certified by a doctor. Results A total of 58 (60% out of 96 patients with long-lasting post-infectious fatigue after laboratory confirmed giardiasis were diagnosed with CFS. In all, 1262 patients had laboratory confirmed giardiasis. At the time of referral (mean illness duration 2.7 years 16% reported improvement, 28% reported no change, and 57% reported progressive course with gradual worsening. Mean FSS score was 6.6. A distinctive pattern of impairment was documented with the SF-36. The physical functioning, vitality (energy/fatigue and social functioning were especially reduced. Long-term sickness absence from studies and work was noted in all patients. Conclusion After giardiasis enteritis at least 5% developed clinical characteristics and functional impairment comparable to previously described post-infectious fatigue syndrome.

  20. Chronic fatigue and chronic fatigue syndrome: shifting boundaries and attributions.

    Science.gov (United States)

    Lloyd, A R

    1998-09-28

    The subjective symptom of "fatigue" is one of the most widespread in the general population and is a major source of healthcare utilization. Prolonged fatigue is often associated with neuropsychological and musculoskeletal symptoms that form the basis of several syndromal diagnoses including chronic fatigue syndrome, fibromyalgia, and neurasthenia, and is clearly not simply the result of a lack of force generation from the muscle. Current epidemiologic research in this area relies predominantly on self-report data to document the prevalence and associations of chronic fatigue. Of necessity, this subjective data source gives rise to uncertain diagnostic boundaries and consequent divergent epidemiologic, clinical, and pathophysiologic research findings. This review will highlight the impact of the case definition and ascertainment methods on the varying prevalence estimates of chronic fatigue syndrome and patterns of reported psychological comorbidty. It will also evaluate the evidence for a true postinfective fatigue syndrome.

  1. The increase of alpha-melanocyte-stimulating hormone in the plasma of chronic fatigue syndrome patients

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    Shishioh-Ikejima Nobue

    2010-08-01

    Full Text Available Abstract Background Despite extensive research, no reliable biological marker for chronic fatigue syndrome (CFS has yet been identified. However, hyperactivation of melanotrophs in the pituitary gland and increased levels of plasma alpha-melanocyte-stimulating hormone (α-MSH have recently been detected in an animal model of chronic stress. Because CFS is considered to be caused partly by chronic stress events, increased α-MSH plasma levels may also occur in CFS patients. We therefore examined α-MSH levels in CFS patients. Methods Fifty-five CFS patients, who were previously diagnosed within 10 years of with the disease, were enrolled in this study. Thirty healthy volunteers were studied as controls. Fasting bloods samples were collected in the morning and evaluated for their plasma levels of α-MSH, adrenocorticotropic hormone (ACTH, serum cortisol and dehydroepiandrosterone sulfate (DHEA-S. Mean levels of α-MSH were compared between the CFS and control groups using Welch's t test. Results The mean plasma α-MSH concentration in the CFS group (17.9 ± 1.0 pg/mL was significantly higher than that in healthy controls (14.5 ± 1.0 pg/mL, p = 0.02. However, there was a wide range of values in the CFS group. The factors correlated with the plasma α-MSH values were analyzed using Spearman's rank correlation. A negative correlation was found between the duration of the CFS and the plasma α-MSH values (p = 0.04, rs = -0.28, but no correlations with ACTH, cortisol or DHEA-S levels were identified (p = 0.55, 0.26, 0.33, respectively. The CFS patients were divided into two groups: patients diagnosed for ≤ 5 years' duration, and those diagnosed for 5-10 years' duration. They were compared with the healthy controls using one-way ANOVA and Tukey-Kramer multiple comparison tests. The mean α-MSH concentration in the ≤ 5 years group was 20.8 ± 1.2 pg/mL, which was significantly higher than that in the healthy controls (p Conclusions CFS patients with

  2. Unraveling the role of perfectionism in chronic fatigue syndrome: is there a distinction between adaptive and maladaptive perfectionism?

    Science.gov (United States)

    Kempke, Stefan; Van Houdenhove, Boudewijn; Luyten, Patrick; Goossens, Lutgarde; Bekaert, Patrick; Van Wambeke, Peter

    2011-04-30

    In the current study, we investigated whether the distinction between adaptive (i.e. high personal standards) and maladaptive (i.e. concern over mistakes and doubt about actions) perfectionism that has been found in the literature, is also valid in patients with chronic fatigue syndrome (CFS). We hypothesized that maladaptive, but not adaptive, perfectionism would be significantly and positively related to severity of fatigue and depression in CFS. We examined this hypothesis in a sample of 192 CFS patients using structural equation modelling (SEM). Although the two perfectionism dimensions were related to each other, results supported a model in which only maladaptive perfectionism was positively related to severity of fatigue and depression. Further, we found that depression fully mediated the effect of maladaptive perfectionism on fatigue. The results suggest that adaptive and maladaptive perfectionism are two distinct, albeit related, dimensions in CFS. Findings of this study have important implications for theory and treatment of CFS, particularly for cognitive-behavioral treatment. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

  3. Complementary and alternative medicine for patients with chronic fatigue syndrome: A systematic review

    Science.gov (United States)

    2011-01-01

    Background Throughout the world, patients with chronic diseases/illnesses use complementary and alternative medicines (CAM). The use of CAM is also substantial among patients with diseases/illnesses of unknown aetiology. Chronic fatigue syndrome (CFS), also termed myalgic encephalomyelitis (ME), is no exception. Hence, a systematic review of randomised controlled trials of CAM treatments in patients with CFS/ME was undertaken to summarise the existing evidence from RCTs of CAM treatments in this patient population. Methods Seventeen data sources were searched up to 13th August 2011. All randomised controlled trials (RCTs) of any type of CAM therapy used for treating CFS were included, with the exception of acupuncture and complex herbal medicines; studies were included regardless of blinding. Controlled clinical trials, uncontrolled observational studies, and case studies were excluded. Results A total of 26 RCTs, which included 3,273 participants, met our inclusion criteria. The CAM therapy from the RCTs included the following: mind-body medicine, distant healing, massage, tuina and tai chi, homeopathy, ginseng, and dietary supplementation. Studies of qigong, massage and tuina were demonstrated to have positive effects, whereas distant healing failed to do so. Compared with placebo, homeopathy also had insufficient evidence of symptom improvement in CFS. Seventeen studies tested supplements for CFS. Most of the supplements failed to show beneficial effects for CFS, with the exception of NADH and magnesium. Conclusions The results of our systematic review provide limited evidence for the effectiveness of CAM therapy in relieving symptoms of CFS. However, we are not able to draw firm conclusions concerning CAM therapy for CFS due to the limited number of RCTs for each therapy, the small sample size of each study and the high risk of bias in these trials. Further rigorous RCTs that focus on promising CAM therapies are warranted. PMID:21982120

  4. Complementary and alternative medicine for patients with chronic fatigue syndrome: A systematic review

    Directory of Open Access Journals (Sweden)

    Cao Huijuan

    2011-10-01

    Full Text Available Abstract Background Throughout the world, patients with chronic diseases/illnesses use complementary and alternative medicines (CAM. The use of CAM is also substantial among patients with diseases/illnesses of unknown aetiology. Chronic fatigue syndrome (CFS, also termed myalgic encephalomyelitis (ME, is no exception. Hence, a systematic review of randomised controlled trials of CAM treatments in patients with CFS/ME was undertaken to summarise the existing evidence from RCTs of CAM treatments in this patient population. Methods Seventeen data sources were searched up to 13th August 2011. All randomised controlled trials (RCTs of any type of CAM therapy used for treating CFS were included, with the exception of acupuncture and complex herbal medicines; studies were included regardless of blinding. Controlled clinical trials, uncontrolled observational studies, and case studies were excluded. Results A total of 26 RCTs, which included 3,273 participants, met our inclusion criteria. The CAM therapy from the RCTs included the following: mind-body medicine, distant healing, massage, tuina and tai chi, homeopathy, ginseng, and dietary supplementation. Studies of qigong, massage and tuina were demonstrated to have positive effects, whereas distant healing failed to do so. Compared with placebo, homeopathy also had insufficient evidence of symptom improvement in CFS. Seventeen studies tested supplements for CFS. Most of the supplements failed to show beneficial effects for CFS, with the exception of NADH and magnesium. Conclusions The results of our systematic review provide limited evidence for the effectiveness of CAM therapy in relieving symptoms of CFS. However, we are not able to draw firm conclusions concerning CAM therapy for CFS due to the limited number of RCTs for each therapy, the small sample size of each study and the high risk of bias in these trials. Further rigorous RCTs that focus on promising CAM therapies are warranted.

  5. Activity Pacing Self-Management in Chronic Fatigue Syndrome: A Randomized Controlled Trial.

    Science.gov (United States)

    Kos, Daphne; van Eupen, Inge; Meirte, Jill; Van Cauwenbergh, Deborah; Moorkens, Greta; Meeus, Mira; Nijs, Jo

    2015-01-01

    To evaluate the effectiveness of an activity pacing self-management (APSM) intervention in improving performance of daily life activities in women with chronic fatigue syndrome (CFS). A total of 33 women with CFS (age 41.1±11.2 yr) were randomly allocated to APSM (experimental group; n=16) or relaxation (control group; n=17). Main outcome measures included the Canadian Occupational Performance Measure (COPM; primary) and Checklist Individual Strength (CIS). COPM scores changed significantly over time in both groups (p=.03). The change in Satisfaction scores showed a significant difference in favor only of APSM (effect size=0.74 [0.11, 1.4]). CIS scores decreased significantly in the experimental group only (peffective in optimizing participation in desired daily life activities in women with CFS. Replication in a larger sample with long-term follow-up is required. Copyright © 2015 by the American Occupational Therapy Association, Inc.

  6. High cocoa polyphenol rich chocolate may reduce the burden of the symptoms in chronic fatigue syndrome

    OpenAIRE

    Mellor Duane D; Rigby Alan S; Beckett Stephen; Sathyapalan Thozhukat; Atkin Stephen L

    2010-01-01

    Abstract Background Chocolate is rich in flavonoids that have been shown to be of benefit in disparate conditions including cardiovascular disease and cancer. The effect of polyphenol rich chocolate in subjects with chronic fatigue syndrome (CFS) has not been studied previously. Methods We conducted a double blinded, randomised, clinical pilot crossover study comparing high cocoa liquor/polyphenol rich chocolate (HCL/PR) in comparison to simulated iso-calorific chocolate (cocoa liquor free/lo...

  7. Exploratory open label, randomized study of acetyl- and propionylcarnitine in chronic fatigue syndrome.

    Science.gov (United States)

    Vermeulen, Ruud C W; Scholte, Hans R

    2004-01-01

    We compared the effects of acetylcarnitine, propionylcarnitine and both compounds on the symptoms of chronic fatigue syndrome (CFS). In an open, randomized fashion we compared 2 g/d acetyl-L-carnitine, 2 g/d propionyl-L-carnitine, and its combination in 3 groups of 30 CFS patients during 24 weeks. Effects were rated by clinical global impression of change. Secondary endpoints were the Multidimensional Fatigue Inventory, McGill Pain Questionnaire, and the Stroop attention concentration test. Scores were assessed 8 weeks before treatment; at randomization; after 8, 16, and 24 weeks of treatment; and 2 weeks later. Clinical global impression of change after treatment showed considerable improvement in 59% of the patients in the acetylcarnitine group and 63% in the propionylcarnitine group, but less in the acetylcarnitine plus propionylcarnitine group (37%). Acetylcarnitine significantly improved mental fatigue (p =.015) and propionylcarnitine improved general fatigue (p =.004). Attention concentration improved in all groups, whereas pain complaints did not decrease in any group. Two weeks after treatment, worsening of fatigue was experienced by 52%, 50%, and 37% in the acetylcarnitine, propionylcarnitine, and combined group, respectively. In the acetylcarnitine group, but not in the other groups, the changes in plasma carnitine levels correlated with clinical improvement. Acetylcarnitine and propionylcarnitine showed beneficial effect on fatigue and attention concentration. Less improvement was found by the combined treatment. Acetylcarnitine had main effect on mental fatigue and propionylcarnitine on general fatigue.

  8. Review of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: an evidence-based approach to diagnosis and management by clinicians.

    Science.gov (United States)

    Bested, Alison C; Marshall, Lynn M

    2015-01-01

    This review was written from the viewpoint of the treating clinician to educate health care professionals and the public about Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS). It includes: the clinical definition of ME/CFS with emphasis on how to diagnose ME/CFS; the etiology, pathophysiology, management approach, long-term prognosis and economic cost of ME/CFS. After reading this review, you will be better able to diagnose and treat your patients with ME/CFS using the tools and information provided. Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a complex, chronic medical condition characterized by symptom clusters that include: pathological fatigue and malaise that is worse after exertion, cognitive dysfunction, immune dysfunction, unrefreshing sleep, pain, autonomic dysfunction, neuroendocrine and immune symptoms. ME/CFS is common, often severely disabling and costly. The Institute of Medicine (IOM) reviewed the ME/CFS literature and estimates that between 836,000 and 2.5 million Americans have ME/CFS at a cost of between 17 and 24 billion dollars annually in the US. The IOM suggested a new name for ME/CFS and called it Systemic Exertion Intolerance Disease (SEID). SEID's diagnostic criteria are less specific and do not exclude psychiatric disorders in the criteria. The 2010 Canadian Community Health Survey discovered that 29% of patients with ME/CFS had unmet health care needs and 20% had food insecurity--lack of access to sufficient healthy foods. ME/CFS can be severely disabling and cause patients to be bedridden. Yet most patients (80%) struggle to get a diagnosis because doctors have not been taught how to diagnose or treat ME/CFS in medical schools or in their post-graduate educational training. Consequently, the patients with ME/CFS suffer. They are not diagnosed with ME/CFS and are not treated accordingly. Instead of compassionate care from their doctors, they are often ridiculed by the very people from whom they seek help

  9. The association between daytime napping and cognitive functioning in chronic fatigue syndrome.

    Directory of Open Access Journals (Sweden)

    Zoe M Gotts

    Full Text Available The precise relationship between sleep and physical and mental functioning in chronic fatigue syndrome (CFS has not been examined directly, nor has the impact of daytime napping. This study aimed to examine self-reported sleep in patients with CFS and explore whether sleep quality and daytime napping, specific patient characteristics (gender, illness length and levels of anxiety and depression, predicted daytime fatigue severity, levels of daytime sleepiness and cognitive functioning, all key dimensions of the illness experience.118 adults meeting the 1994 CDC case criteria for CFS completed a standardised sleep diary over 14 days. Momentary functional assessments of fatigue, sleepiness, cognition and mood were completed by patients as part of usual care. Levels of daytime functioning and disability were quantified using symptom assessment tools, measuring fatigue (Chalder Fatigue Scale, sleepiness (Epworth Sleepiness Scale, cognitive functioning (Trail Making Test, Cognitive Failures Questionnaire, and mood (Hospital Anxiety and Depression Scale.Hierarchical Regressions demonstrated that a shorter time since diagnosis, higher depression and longer wake time after sleep onset predicted 23.4% of the variance in fatigue severity (p <.001. Being male, higher depression and more afternoon naps predicted 25.6% of the variance in objective cognitive dysfunction (p <.001. Higher anxiety and depression and morning napping predicted 32.2% of the variance in subjective cognitive dysfunction (p <.001. When patients were classified into groups of mild and moderate sleepiness, those with longer daytime naps, those who mainly napped in the afternoon, and those with higher levels of anxiety, were more likely to be in the moderately sleepy group.Napping, particularly in the afternoon is associated with poorer cognitive functioning and more daytime sleepiness in CFS. These findings have clinical implications for symptom management strategies.

  10. Chronic fatigue syndrome: illness severity, sedentary lifestyle, blood volume and evidence of diminished cardiac function.

    Science.gov (United States)

    Hurwitz, Barry E; Coryell, Virginia T; Parker, Meela; Martin, Pedro; Laperriere, Arthur; Klimas, Nancy G; Sfakianakis, George N; Bilsker, Martin S

    2009-10-19

    The study examined whether deficits in cardiac output and blood volume in a CFS (chronic fatigue syndrome) cohort were present and linked to illness severity and sedentary lifestyle. Follow-up analyses assessed whether differences in cardiac output levels between CFS and control groups were corrected by controlling for cardiac contractility and TBV (total blood volume). The 146 participants were subdivided into two CFS groups based on symptom severity data, severe (n=30) and non-severe (n=26), and two healthy non-CFS control groups based on physical activity, sedentary (n=58) and non-sedentary (n=32). Controls were matched to CFS participants using age, gender, ethnicity and body mass. Echocardiographic measures indicated that the severe CFS participants had 10.2% lower cardiac volume (i.e. stroke index and end-diastolic volume) and 25.1% lower contractility (velocity of circumferential shortening corrected by heart rate) than the control groups. Dual tag blood volume assessments indicated that the CFS groups had lower TBV, PV (plasma volume) and RBCV (red blood cell volume) than control groups. Of the CFS subjects with a TBV deficit (i.e. > or = 8% below ideal levels), the mean+/-S.D. percentage deficit in TBV, PV and RBCV were -15.4+/-4.0, -13.2+/-5.0 and -19.1+/-6.3% respectively. Lower cardiac volume levels in CFS were substantially corrected by controlling for prevailing TBV deficits, but were not affected by controlling for cardiac contractility levels. Analyses indicated that the TBV deficit explained 91-94% of the group differences in cardiac volume indices. Group differences in cardiac structure were offsetting and, hence, no differences emerged for left ventricular mass index. Therefore the findings indicate that lower cardiac volume levels, displayed primarily by subjects with severe CFS, were not linked to diminished cardiac contractility levels, but were probably a consequence of a co-morbid hypovolaemic condition. Further study is needed to address

  11. The search for pain relief in people with chronic fatigue syndrome: a descriptive study.

    Science.gov (United States)

    Marshall, Rebecca; Paul, Lorna; Wood, Les

    2011-07-01

    The purpose of this study was to investigate the use and perceived benefit of complimentary and alternative medicine (CAM) and physiotherapy treatments tried by people with chronic fatigue syndrome (CFS) to ease painful symptoms. This study used a descriptive, cross-sectional design. People with CFS who experienced pain were recruited to this study. Participants were asked during a semistructured interview about the treatments they had tried to relieve their pain. Each interview was conducted in the home of the participant. Fifty participants were recruited, of which, 10 participants were severely disabled by CFS. Eighteen participants were trying different forms of CAM treatment for pain relief at the time of assessment. Three participants were currently receiving physiotherapy. Throughout the duration of their illness 45 participants reported trying 19 different CAM treatments in the search for pain relief. Acupuncture was reported to provide the most pain relief (n=16). Twenty-seven participants reported a total of 16 different interventions prescribed by their physiotherapist. The results of this study suggest some physiotherapy and CAM treatments may help people manage painful CFS symptoms. Future research should be directed to evaluating the effectiveness of interventions such as acupuncture or gentle soft tissue therapies to reduce pain in people with CFS.

  12. Xenotropic Murine Leukemia Virus-Related Virus in Monozygotic Twins Discordant for Chronic Fatigue Syndrome

    Science.gov (United States)

    Jerome, Keith R.; Diem, Kurt; Huang, Meei-Li; Selke, Stacy; Corey, Lawrence; Buchwald, Dedra

    2011-01-01

    A recent report suggested an association between xenotropic murine leukemia virus-related virus (XMRV) and chronic fatigue syndrome (CFS). If confirmed, this would suggest that antiretroviral therapy might benefit patients suffering from CFS. We validated a set of assays for XMRV, and evaluated the prevalence of XMRV in a cohort of monozygotic twins discordant for CFS. Stored PBMC were tested with 3 separate PCR assays (one of which was nested) for XMRV DNA, and serum/plasma was tested for XMRV RNA by reverse transcription (RT)-PCR. None of the PBMC samples from the twins with CFS or their unaffected co-twins were positive for XMRV, by any of the assays. One plasma sample, from an unaffected co-twin, was reproducibly positive by RT-PCR. However, serum from the same day was negative, as was a followup plasma sample obtained 2 days after the positive specimen. These data do not support an association of XMRV with CFS. PMID:21795004

  13. Comparison of chronic fatigue syndrome/myalgic encephalopathy with other disorders: an observational study.

    Science.gov (United States)

    Knudsen, Ak; Lervik, Lv; Harvey, Sb; Løvvik, Cms; Omenås, An; Mykletun, A

    2012-05-01

    To examine the level of activity in online discussion forums for chronic fatigue syndrome/myalgic encephalopathy (CFS/ME) compared to other disorders. We hypothesized the level of activity to be higher in CFS/ME online discussion forums. Observational study Norway, which has more than 80% household coverage in internet access, September 2009 Twelve Norwegian disorder-related online discussion forums Number of registered users and number of posted messages on each discussion forum Two forums were targeted towards individuals with CFS/ME. These forums had the highest number of registered users per estimated 1,000 cases in the population (50.5 per 1,000 and 29.7 per 1,000), followed by a site for drug dependency (5.4 per 1,000). Counting the number of posted messages per 1,000 cases gave similar indications of high online activity in the CFS/ME discussion forums. CFS/ME online forums had more than ten times the relative activity of any other disorder or condition related forum. This high level of activity may have multiple explanations. Individuals suffering from a stigmatized condition of unknown aetiology may use the internet to look for explanations of symptoms or to seek out alternative treatments. Internet forum activity may also be reinforced by the creation of in-group identity and pre-morbid personality traits. More knowledge on the type and quality of information provided in online forums is urgently needed.

  14. Chronic fatigue syndrome, fibromyalgia, and related illnesses: a clinical model of assessment and intervention.

    Science.gov (United States)

    Friedberg, Fred

    2010-06-01

    A clinically informative behavioral literature on chronic fatigue syndrome (CFS) and fibromyalgia (FM) has emerged over the past decade. The purpose of this article is to (a) define these conditions and their less severe counterparts, i.e., unexplained chronic fatigue (UCF) and chronic widespread pain; (b) briefly review the behavioral theory and intervention literature on CFS and FM; and (c) describe a user-friendly clinical model of assessment and intervention for these illnesses. The assessments described will facilitate understanding of the somewhat unusual and puzzling somatic presentations that characterize these patients. Using an individualized cognitive-behavioral approach the mental health clinician can offer significant help to these often stigmatized and medically underserved patients. (c) 2010 Wiley Periodicals, Inc.

  15. What is in a name? Comparing diagnostic criteria for chronic fatigue syndrome with or without fibromyalgia.

    Science.gov (United States)

    Meeus, Mira; Ickmans, Kelly; Struyf, Filip; Kos, Daphne; Lambrecht, Luc; Willekens, Barbara; Cras, Patrick; Nijs, Jo

    2016-01-01

    The current study had two objectives. (1) to compare objective and self-report measures in patients with chronic fatigue syndrome (CFS) according to the 1994 Center for Disease Control (CDC) criteria, patients with multiple sclerosis (MS), and healthy controls, and (2) to contrast CFS patients who only fulfill CDC criteria to those who also fulfill the criteria for myalgic encephalomyelitis (ME), the 2003 Canadian criteria for ME/CFS, or the comorbid diagnosis of fibromyalgia (FM). One hundred six participants (48 CFS patients diagnosed following the 1994 CDC criteria, 19 MS patients, and 39 healthy controls) completed questionnaires assessing symptom severity, quality of life, daily functioning, and psychological factors. Objective measures consisted of activity monitoring, evaluation of maximal voluntary contraction and muscle recovery, and cognitive performance. CFS patients were screened whether they also fulfilled ME criteria, the Canadian criteria, and the diagnosis of FM. CFS patients scored higher on symptom severity, lower on quality of life, and higher on depression and kinesiophobia and worse on MVC, muscle recovery, and cognitive performance compared to the MS patients and the healthy subjects. Daily activity levels were also lower compared to healthy subjects. Only one difference was found between those fulfilling the ME criteria and those who did not regarding the degree of kinesiophobia (lower in ME), while comorbidity for FM significantly increased the symptom burden. CFS patients report more severe symptoms and are more disabled compared to MS patients and healthy controls. Based on the present study, fulfillment of the ME or Canadian criteria did not seem to give a clinically different picture, whereas a diagnosis of comorbid FM selected symptomatically worse and more disabled patients.

  16. Do evidence based interventions for chronic fatigue syndrome improve sleep? A systematic review and narrative synthesis.

    Science.gov (United States)

    Russell, Charlotte; Kyle, Simon D; Wearden, Alison J

    2017-06-01

    Cognitive behavioural therapy (CBT) and graded exercise therapy (GET) are recommended evidence based treatments for chronic fatigue syndrome (CFS), with research supporting their effectiveness in reducing fatigue and functional impairment. However, little research has focussed on the effect of these treatments on sleep, despite high reported sleep disturbance in CFS. Using a narrative synthesis approach, we aimed to 1) systematically identify and summarise the current evidence for the effectiveness of CBT and GET in improving sleep; 2) consider factors influencing treatment effectiveness, including incorporation of sleep management techniques; and 3) consider the appropriateness of sleep outcome measures used within evaluations. Studies evaluating CBT and/or GET for CFS, and including a sleep outcome were eligible for inclusion. Eight studies were identified. We found that GET interventions can improve sleep but this effect is inconsistent across studies. For CBT the evidence is limited with only one of two evaluations demonstrating sleep-related improvements. We conclude from existing research that we know little about the effects of including sleep management components within CBT and GET interventions. We suggest that future research should explore the effectiveness of sleep components within interventions, and sleep specific interventions, using comprehensive outcome measures that fully capture the range of sleep difficulties experienced in CFS. Copyright © 2016 Elsevier Ltd. All rights reserved.

  17. RELIABILITY OF PHYSIOLOGICAL, PSYCHOLOGICAL AND COGNITIVE VARIABLES IN CHRONIC FATIGUE SYNDROME AND THE ROLE OF GRADED EXERCISE

    Directory of Open Access Journals (Sweden)

    Karen E. Wallman

    2005-12-01

    Full Text Available The objective of this study was to assess variability in symptoms and physical capabilities in chronic fatigue syndrome (CFS participants both before and after a graded exercise intervention. Sixty-one CFS subjects participated in a 12-week randomized controlled trial of either graded exercise (n =32 or relaxation/stretching therapy (n = 29. Specific physiological, psychological and cognitive variables were assessed once weekly over a four-week period both prior to and after the intervention period. All scores were assessed for reliability using an intraclass correlation coefficient (ICC. Apart from mental and physical fatigue, baseline ICC scores for all variables assessed were moderately to highly reliable, indicating minimal variability. Baseline scores for mental and physical fatigue were of questionable reliability, indicating a fluctuating nature to these symptoms (R1 = 0.64 and 0.60, respectively. Variability in scores for mental fatigue was reduced after graded exercise to an acceptable classification (R1 = 0.76. Results from this study support a variable nature to the symptoms of mental and physical fatigue only. Consequently, in order to more accurately report the nature of mental and physical fatigue in CFS, future studies should consider using repeated-measures analysis when assessing these symptoms. Graded exercise resulted in the reclassification of scores for mental fatigue from questionable to acceptable reliability

  18. Bottom-up proteomics suggests an association between differential expression of mitochondrial proteins and chronic fatigue syndrome

    Science.gov (United States)

    Ciregia, F; Kollipara, L; Giusti, L; Zahedi, R P; Giacomelli, C; Mazzoni, M R; Giannaccini, G; Scarpellini, P; Urbani, A; Sickmann, A; Lucacchini, A; Bazzichi, L

    2016-01-01

    Chronic fatigue syndrome (CFS) is a debilitating and complex disorder characterized by unexplained fatigue not improved by rest. An area of investigation is the likely connection of CFS with defective mitochondrial function. In a previous work, we investigated the proteomic salivary profile in a couple of monozygotic twins discordant for CFS. Following this work, we analyzed mitochondrial proteins in the same couple of twins. Nano-liquid chromatography electrospray ionization mass spectrometry (nano-LC-MS) was used to study the mitochondria extracted from platelets of the twins. Subsequently, we selected three proteins that were validated using western blot analysis in a big cohort of subjects (n=45 CFS; n=45 healthy), using whole saliva (WS). The selected proteins were as follows: aconitate hydratase (ACON), ATP synthase subunit beta (ATPB) and malate dehydrogenase (MDHM). Results for ATPB and ACON confirmed their upregulation in CFS. However, the MDHM alteration was not confirmed. Thereafter, seeing the great variability of clinical features of CFS patients, we decided to analyze the expression of our proteins after splitting patients according to clinical parameters. For each marker, the values were actually higher in the group of patients who had clinical features similar to the ill twin. In conclusion, these results suggest that our potential markers could be one of the criteria to be taken into account for helping in diagnosis. Furthermore, the identification of biomarkers present in particular subgroups of CFS patients may help in shedding light upon the complex entity of CFS. Moreover, it could help in developing tailored treatments. PMID:27676445

  19. Chronic Fatigue Syndrome (For Parents)

    Science.gov (United States)

    ... diagnoses increase, many people (health professionals and the public alike) doubt CFS exists or consider it a ... abnormalities and risk factors (including genetic predisposition, age, gender, ... in relation to cognitive skills, concentration, memory, personality, and overall ...

  20. General Situation of Acupuncture and Tuina for Chronic Fatigue Syndrome

    Institute of Scientific and Technical Information of China (English)

    韩晶; 胡幼平

    2009-01-01

    @@ Chronic fatigue syndrome(CFS)refers to a poor adaptation in physiology,psychology and social activities.It iS a critical status between health and sickness,also known as sub.health,and becomes a hot point in the medical study in the twenty first century,and its incidence is about 70%in the population of China[1-4].Its main manifestations Can be divided into four major categories:first psychological symptoms,manifested by low spirit,low emotion,depression and unhappiness,or frustration and easy anger,anxiety and stress,susplctousness and jealousy,poor sicep,poor memory,poor concentration.

  1. Symptom occurrence in persons with chronic fatigue syndrome.

    Science.gov (United States)

    Jason, L A; Torres-Harding, S R; Carrico, A W; Taylor, R R

    2002-02-01

    This investigation compared differences in the occurrence of symptoms in participants with CFS, melancholic depression, and no fatigue (controls). The following Fukuda et al. [Ann. Intern. Med. 121 (1994) 953] criteria symptoms differentiated the CFS group from controls, but did not differentiate the melancholic depression group from controls: headaches, lymph node pain, sore throat, joint pain, and muscle pain. In addition, participants with CFS uniquely differed from controls in the occurrence of muscle weakness at multiple sites as well as in the occurrence of various cardiopulmonary, neurological, and other symptoms not currently included in the current case definition. Implications of these findings are discussed.

  2. Detection of Mycotoxins in Patients with Chronic Fatigue Syndrome

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    Roberta A. Madison

    2013-04-01

    Full Text Available Over the past 20 years, exposure to mycotoxin producing mold has been recognized as a significant health risk. Scientific literature has demonstrated mycotoxins as possible causes of human disease in water-damaged buildings (WDB. This study was conducted to determine if selected mycotoxins could be identified in human urine from patients suffering from chronic fatigue syndrome (CFS. Patients (n = 112 with a prior diagnosis of CFS were evaluated for mold exposure and the presence of mycotoxins in their urine. Urine was tested for aflatoxins (AT, ochratoxin A (OTA and macrocyclic trichothecenes (MT using Enzyme Linked Immunosorbent Assays (ELISA. Urine specimens from 104 of 112 patients (93% were positive for at least one mycotoxin (one in the equivocal range. Almost 30% of the cases had more than one mycotoxin present. OTA was the most prevalent mycotoxin detected (83% with MT as the next most common (44%. Exposure histories indicated current and/or past exposure to WDB in over 90% of cases. Environmental testing was performed in the WDB from a subset of these patients. This testing revealed the presence of potentially mycotoxin producing mold species and mycotoxins in the environment of the WDB. Prior testing in a healthy control population with no history of exposure to a WDB or moldy environment (n = 55 by the same laboratory, utilizing the same methods, revealed no positive cases at the limits of detection.

  3. Detection of mycotoxins in patients with chronic fatigue syndrome.

    Science.gov (United States)

    Brewer, Joseph H; Thrasher, Jack D; Straus, David C; Madison, Roberta A; Hooper, Dennis

    2013-04-11

    Over the past 20 years, exposure to mycotoxin producing mold has been recognized as a significant health risk. Scientific literature has demonstrated mycotoxins as possible causes of human disease in water-damaged buildings (WDB). This study was conducted to determine if selected mycotoxins could be identified in human urine from patients suffering from chronic fatigue syndrome (CFS). Patients (n = 112) with a prior diagnosis of CFS were evaluated for mold exposure and the presence of mycotoxins in their urine. Urine was tested for aflatoxins (AT), ochratoxin A (OTA) and macrocyclic trichothecenes (MT) using Enzyme Linked Immunosorbent Assays (ELISA). Urine specimens from 104 of 112 patients (93%) were positive for at least one mycotoxin (one in the equivocal range). Almost 30% of the cases had more than one mycotoxin present. OTA was the most prevalent mycotoxin detected (83%) with MT as the next most common (44%). Exposure histories indicated current and/or past exposure to WDB in over 90% of cases. Environmental testing was performed in the WDB from a subset of these patients. This testing revealed the presence of potentially mycotoxin producing mold species and mycotoxins in the environment of the WDB. Prior testing in a healthy control population with no history of exposure to a WDB or moldy environment (n = 55) by the same laboratory, utilizing the same methods, revealed no positive cases at the limits of detection.

  4. Pilot study investigating the utility of a specialized online symptom management program for individuals with myalgic encephalomyelitis/chronic fatigue syndrome as compared to an online meditation program

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    Arroll MA

    2014-09-01

    Full Text Available Megan A Arroll, Elizabeth A Attree, Claire L Marshall, Christine P DanceyChronic Illness Research Team, School of Psychology, University of East London, London, UKBackground: Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS is a long-term, debilitating condition that impacts numerous areas of individuals' lives. The two predominant treatment options for ME/CFS are cognitive behavioral therapy and graded exercise therapy; however, many people have found these techniques unacceptable or even damaging. This pilot study aimed to evaluate the utility of a specialized online symptom management program for ME/CFS in comparison to an online meditation program in an effort to ascertain whether this tool could be a further option for those with ME/CFS.Methods: This experimental design consisted of two interventions: a specialized online symptoms management program (N=19 and a control intervention based on an online meditation website (N=9. A battery of questionnaires, including measures of multidimensional fatigue, illness-specific symptoms, perceived control, and mindful awareness, were completed before the participants commenced use of the programs and following 8 weeks' use.Results: Significant differences were found in the areas of chance and powerful others' locus of control, and sleeping difficulties, but not in ME/CFS symptomatology overall.Conclusion: The specialized online program described in this study warrants further investigation, as it appears to influence perceived control and key ME/CFS symptoms over time.Keywords: ME/CFS, perceived control, sleep, outcomes, online intervention

  5. Qigong exercise alleviates fatigue, anxiety, and depressive symptoms, improves sleep quality, and shortens sleep latency in persons with chronic fatigue syndrome-like illness.

    Science.gov (United States)

    Chan, Jessie S M; Ho, Rainbow T H; Chung, Ka-Fai; Wang, Chong-Wen; Yao, Tzy-Jyun; Ng, Siu-Man; Chan, Cecilia L W

    2014-01-01

    Objectives. To evaluate the effectiveness of Baduanjin Qigong exercise on sleep, fatigue, anxiety, and depressive symptoms in chronic fatigue syndrome- (CFS-) like illness and to determine the dose-response relationship. Methods. One hundred fifty participants with CFS-like illness (mean age = 39.0, SD = 7.9) were randomly assigned to Qigong and waitlist. Sixteen 1.5-hour Qigong lessons were arranged over 9 consecutive weeks. Pittsburgh Sleep Quality Index (PSQI), Chalder Fatigue Scale (ChFS), and Hospital Anxiety and Depression Scale (HADS) were assessed at baseline, immediate posttreatment, and 3-month posttreatment. The amount of Qigong self-practice was assessed by self-report. Results. Repeated measures analyses of covariance showed a marginally nonsignificant (P = 0.064) group by time interaction in the PSQI total score, but it was significant for the "subjective sleep quality" and "sleep latency" items, favoring Qigong exercise. Improvement in "subjective sleep quality" was maintained at 3-month posttreatment. Significant group by time interaction was also detected for the ChFS and HADS anxiety and depression scores. The number of Qigong lessons attended and the amount of Qigong self-practice were significantly associated with sleep, fatigue, anxiety, and depressive symptom improvement. Conclusion. Baduanjin Qigong was an efficacious and acceptable treatment for sleep disturbance in CFS-like illness. This trial is registered with Hong Kong Clinical Trial Register: HKCTR-1380.

  6. Qigong Exercise Alleviates Fatigue, Anxiety, and Depressive Symptoms, Improves Sleep Quality, and Shortens Sleep Latency in Persons with Chronic Fatigue Syndrome-Like Illness

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    Jessie S. M. Chan

    2014-01-01

    Full Text Available Objectives. To evaluate the effectiveness of Baduanjin Qigong exercise on sleep, fatigue, anxiety, and depressive symptoms in chronic fatigue syndrome- (CFS- like illness and to determine the dose-response relationship. Methods. One hundred fifty participants with CFS-like illness (mean age = 39.0, SD = 7.9 were randomly assigned to Qigong and waitlist. Sixteen 1.5-hour Qigong lessons were arranged over 9 consecutive weeks. Pittsburgh Sleep Quality Index (PSQI, Chalder Fatigue Scale (ChFS, and Hospital Anxiety and Depression Scale (HADS were assessed at baseline, immediate posttreatment, and 3-month posttreatment. The amount of Qigong self-practice was assessed by self-report. Results. Repeated measures analyses of covariance showed a marginally nonsignificant (P= 0.064 group by time interaction in the PSQI total score, but it was significant for the “subjective sleep quality” and “sleep latency” items, favoring Qigong exercise. Improvement in “subjective sleep quality” was maintained at 3-month posttreatment. Significant group by time interaction was also detected for the ChFS and HADS anxiety and depression scores. The number of Qigong lessons attended and the amount of Qigong self-practice were significantly associated with sleep, fatigue, anxiety, and depressive symptom improvement. Conclusion. Baduanjin Qigong was an efficacious and acceptable treatment for sleep disturbance in CFS-like illness. This trial is registered with Hong Kong Clinical Trial Register: HKCTR-1380.

  7. Chronic fatigue syndrome in an ethnically diverse population: the influence of psychosocial adversity and physical inactivity

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    Wessely Simon

    2011-03-01

    Full Text Available Abstract Background Chronic fatigue syndrome (CFS is a complex multifactorial disorder. This paper reports the prevalence of chronic fatigue (CF and CFS in an ethnically diverse population sample and tests whether prevalence varies by social adversity, social support, physical inactivity, anxiety and depression. Methods Analysis of survey data linking the Health Survey for England (1998 and 1999 and the Ethnic Minority Psychiatric Illness Rates in the Community (EMPIRIC study undertaken in 2000. The study population comprised a national population sample of 4,281 people ages 16 to 74 years. CF and CFS were operationally defined on the basis of an interview in the EMPIRIC study, alongside questions about psychosocial risk factors. Previous illnesses were reported in the Health Survey for England during 1998 and 1999, as was physical inactivity. Results All ethnic minority groups had a higher prevalence of CFS than the White group. The lowest prevalence was 0.8% in the White group, and it was highest at 3.5% in the Pakistani group (odds ratio (OR, 4.1; 95% confidence interval (95% CI, 1.6 to 10.4. Anxiety (OR, 1.8; 95% CI, 1.4 to 2.2, depression (OR, 1.4; 95% CI, 1.1 to 1.8, physical inactivity (OR, 2.0; 95% CI, 1.1 to 3.8, social strain (OR, 1.24; 95% CI, 1.04 to 1.48 and negative aspects of social support (OR, 2.12; 95% CI, 1.4 to 3.3 were independent risk factors for CFS in the overall sample. Together these risk factors explained ethnic differences in the prevalence of CFS, but no single risk factor could explain a higher prevalence in all ethnic groups. Conclusions The prevalence of CFS, but not CF, varies by ethnic group. Anxiety, depression, physical inactivity, social strain and negative aspects of social support together accounted for prevalence differences of CFS in the overall sample.

  8. Influence of symptom expectancies on stair-climbing performance in chronic fatigue syndrome: effect of study context.

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    Heins, Marianne; Knoop, Hans; Nijs, Jo; Feskens, Remco; Meeus, Mira; Moorkens, Greta; Bleijenberg, Gijs

    2013-06-01

    In patients with chronic fatigue syndrome (CFS), performance of physical activities may be affected by an anticipated increase in symptoms after these activities. Nijs et al. previously studied the influence of symptom expectancies and related psychological processes on the performance of an isolated physical activity [Nijs J, Meeus M, Heins M, Knoop H, Moorkens G, Bleijenberg G. Kinesiophobia, catastrophizing and anticipated symptoms before stair climbing in chronic fatigue syndrome: an experimental study. Disabil Rehabil 2012. doi: 10.3109/09638288.2011.641661 .]. We aimed to validate the previous findings in a larger group of patients in a different setting. We also extended the possible underlying psychological processes studied. In 49 CFS patients, we measured performance (duration and increase in heart rate) during self-paced climbing and descending of two floors of stairs. Before this task, patients rated experienced fatigue and anticipated fatigue after stair climbing. In addition, kinesiophobia, catastrophising and focusing on bodily symptoms were measured. Using correlational and regression analyses, we tested whether performance during stair climbing could be explained by experienced and anticipated fatigue and psychological factors. Longer duration of stair climbing correlated with higher anticipated fatigue, independently of sex, age, body mass index and fatigue before stair climbing. Focusing on bodily symptoms and fatigue-related catastrophising were related to anticipated fatigue. Symptom expectations affect the performance of physical activity in CFS patients, possibly through focusing on bodily symptoms and catastrophising. These findings partially contradict the findings of the previous study, which stresses the importance of study context in conducting this type of experiments (i.e., patient characteristics, instructions).

  9. Regional distribution of fatiguing illnesses in the United States: a pilot study

    OpenAIRE

    2004-01-01

    Abstract Background Chronic fatigue syndrome (CFS) is a debilitating illness with no known cause or effective therapy. Population-based epidemiologic data on CFS prevalence are critical to put CFS in a realistic context for public health officials and others responsible for allocating resources. Methods We conducted a pilot random-digit-dialing survey to estimate the prevalence of fatiguing illnesses in different geographic regions and in urban and rural populations of the United States. This...

  10. Failure to Confirm XMRV/MLVs in the Blood of Patients with Chronic Fatigue Syndrome: A Multi-laboratory Study

    Science.gov (United States)

    Simmons, Graham; Glynn, Simone A.; Komaroff, Anthony L.; Mikovits, Judy A.; Tobler, Leslie H.; Hackett, John; Tang, Ning; Switzer, William M.; Heneine, Walid; Hewlett, Indira K.; Zhao, Jiangqin; Lo, Shyh-Ching; Alter, Harvey J.; Linnen, Jeffrey M.; Gao, Kui; Coffin, John M.; Kearney, Mary F.; Ruscetti, Francis W.; Pfost, Max A.; Bethel, James; Kleinman, Steven; Holmberg, Jerry A.; Busch, Michael P.

    2012-01-01

    Murine leukemia viruses (MLV), including xenotropic-MLV-related virus (XMRV), have been controversially linked to chronic fatigue syndrome (CFS). To explore this issue in greater depth, we compiled coded replicate samples of blood from 15 subjects previously reported to be XMRV/MLV-positive (14 with CFS) and from 15 healthy donors previously determined to be negative for the viruses. These samples were distributed in a blinded fashion to nine laboratories which performed assays designed to detect XMRV/MLV nucleic acid, virus replication, and antibody. Only two laboratories reported evidence of XMRV/MLVs; however, replicate sample results showed disagreement and reactivity was similar among CFS subjects and negative controls. These results indicate that current assays do not reproducibly detect XMRV/MLV in blood samples and that blood donor screening is not warranted. PMID:21940862

  11. The expressed needs of people with Chronic Fatigue Syndrome/Myalgic Encephalomyelitis: A systematic review

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    Campion Peter

    2009-12-01

    Full Text Available Abstract Background We aimed to review systematically the needs for support in managing illness and maintaining social inclusion expressed by people with chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME Methods We carried out a systematic review of primary research and personal ('own' stories expressing the needs of people with CFS/ME. Structured searches were carried out on Medline, AMED, CINAHL, EMBASE, ASSIA, CENTRAL, and other health, social and legal databases from inception to November 2007. Study inclusion, data extraction and risk of bias were assessed independently in duplicate. Expressed needs were tabulated and a conceptual framework developed through an iterative process. Results Thirty two quantitative and qualitative studies, including the views of over 2500 people with CFS/ME with mainly moderate or severe illness severity, met the inclusion criteria. The following major support needs emerged: 1 The need to make sense of symptoms and gain diagnosis, 2 for respect and empathy from service providers, 3 for positive attitudes and support from family and friends, 4 for information on CFS/ME, 5 to adjust views and priorities, 6 to develop strategies to manage impairments and activity limitations, and 7 to develop strategies to maintain/regain social participation. Conclusions Although the studies were heterogeneous, there was consistent evidence that substantial support is needed to rebuild lives. Gaining support depends - most importantly - on the ability of providers of health and social care, colleagues, friends and relatives, and those providing educational and leisure services, to understand and respond to those needs.

  12. The Development of a Revised Canadian Myalgic Encephalomyelitis Chronic Fatigue Syndrome Case Definition

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    Leonard A. Jason

    2010-01-01

    Full Text Available Problem statement: Several investigators have indicated that case definitions for Chronic Fatigue Syndrome (CFS are characterized by vaguely worded criteria that lack operational definitions and guidelines. The most widely used CFS case definition is the Fukuda et al. criteria, which uses polythetic criteria (i.e., patients are only required to have four out of a possible eight symptoms. Yet two of these eight symptoms (post-exertional malaise and memory/concentration problems are an essential feature of this illness and the Fukuda et al. criteria do not require that these symptoms be present among all patients. Significant methodological problems could occur if investigators in different settings recruit samples with different percentages of these core symptoms. In contrast, the Canadian clinical case definition does require specific ME/CFS symptoms such as post-exertional malaise and memory/concentration problems. The provision of operationally explicit, objective criteria on specific key symptoms might reduce criterion variance as a source of unreliability. In addition, the use of structured interview schedules will ensure that symptoms are assessed in a consistent way across settings. Conclusion/Recommendations: In this article, we specified explicit rules for determining whether critical symptoms meet ME/CFS criteria using a revised Canadian case definition and a questionnaire has been developed to assess core symptoms. It is hoped that these developments will lead to increased reliability of this revised Canadian case definition as well as more frequent use of these criteria by investigators.

  13. Amisulpride vs. fluoxetine treatment of chronic fatigue syndrome: a pilot study.

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    Pardini, Matteo; Guida, Silvia; Primavera, Alberto; Krueger, Frank; Cocito, Leonardo; Gialloreti, Leonardo Emberti

    2011-03-01

    Different pharmacologic agents have been evaluated in the treatment of Chronic Fatigue Syndrome (CFS), albeit with moderate efficacy. Among the compounds thought to present with potential to be efficacious in CFS patients stands out low-dose amisulpride, a substituted benzamide that has been shown to be an useful treatment for conditions which exhibit some overlap with CFS such as dysthymia and somatoform disorders. We thus recruited forty non-depressed CFS patients that were randomized to receive either amisulpride 25mg bid, or fluoxetine 20mg uid; all subjects were un-blinded to the treatment regimen. At the time of enrollment in the study and after twelve weeks of treatment, enrolled subjects completed the Krupp Fatigue Severity Scale, the Hospital Anxiety and Depression Scale and a visual analog scale focused on pain and bodily discomfort. Moreover, all subjects were evaluated by a clinician, blinded to the treatment regimen, using the Clinical Global Impression Severity Scale. Our data revealed a significant improvement both in self-report, and observer-based measures for the amisulpride-treated, but not for the fluoxetine-treated patients. Amisulpride-treated subjects also presented with a significant reduction of somatic complaints, while the amisulpride effect on anxiety and mood levels was not significant. Both drugs were equally well tolerated. Summing up, we showed a positive symptomatic effect of amisulpride, compared to SSRI treatment, in a group of non-depressed CSF patients on self-report and on observer-based measures of fatigue and somatic complaints. If confirmed by larger, blinded studies, amisulpride thus could represent an effective approach to this difficult-to-treat condition.

  14. Patterns of food avoidance in chronic fatigue syndrome: is there a case for dietary recommendations?

    Directory of Open Access Journals (Sweden)

    J. Trabal

    Full Text Available Objectives: To assess the dietary habits and food avoidance-behavior in patients with Chronic Fatigue Syndrome (CFS. Methods: Cross-sectional pilot study with 28 patients diagnosed with severe CFS. Eating habits were assessed with a food frequency questionnaire and 3-day food records. We analyzed variables related to dietary restrictions induced by symptoms or external information. Results: The most prevalent restrictions were for dairy products and gluten-containing grains, with 22 and 15 restricting patients, respectively. Patients reported different digestive symptoms, which did not improve with the use of exclusion diets. Thirteen patients had received information against the intake of certain foods through different sources. Six cases of grains restriction and 11 of dairy were compatible with a counseling-induced pattern of exclusion. Conclusions: There is not a homogeneous pattern of food avoidance. Dietary restrictions should be based on a proven food allergy or intolerance. Dietary counseling should be based on sound nutritional knowledge.

  15. Lyme Disease Diagnosed by Alternative Methods: A Phenotype Similar to That of Chronic Fatigue Syndrome.

    Science.gov (United States)

    Patrick, David M; Miller, Ruth R; Gardy, Jennifer L; Parker, Shoshana M; Morshed, Muhammad G; Steiner, Theodore S; Singer, Joel; Shojania, Kam; Tang, Patrick

    2015-10-01

    A subset of patients reporting a diagnosis of Lyme disease can be described as having alternatively diagnosed chronic Lyme syndrome (ADCLS), in which diagnosis is based on laboratory results from a nonreference Lyme specialty laboratory using in-house criteria. Patients with ADCLS report symptoms similar to those reported by patients with chronic fatigue syndrome (CFS). We performed a case-control study comparing patients with ADCLS and CFS to each other and to both healthy controls and controls with systemic lupus erythematosus (SLE). Subjects completed a history, physical exam, screening laboratory tests, 7 functional scales, reference serology for Lyme disease using Centers for Disease Control and Prevention criteria, reference serology for other tick-associated pathogens, and cytokine expression studies. The study enrolled 13 patients with ADCLS (12 of whom were diagnosed by 1 alternative US laboratory), 25 patients with CFS, 25 matched healthy controls, and 11 SLE controls. Baseline clinical data and functional scales indicate significant disability among ADCLS and CFS patients and many important differences between these groups and controls, but no significant differences between each other. No ADCLS patient was confirmed as having positive Lyme serology by reference laboratory testing, and there was no difference in distribution of positive serology for other tick-transmitted pathogens or cytokine expression across the groups. In British Columbia, a setting with low Lyme disease incidence, ADCLS patients have a similar phenotype to that of CFS patients. Disagreement between alternative and reference laboratory Lyme testing results in this setting is most likely explained by false-positive results from the alternative laboratory. © The Author 2015. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  16. Adolescent chronic fatigue syndrome; a follow-up study displays concurrent improvement of circulatory abnormalities and clinical symptoms.

    Science.gov (United States)

    Sulheim, Dag; Hurum, Harald; Helland, Ingrid B; Thaulow, Erik; Wyller, Vegard Bruun

    2012-03-21

    The pathophysiology of chronic fatigue syndrome (CFS) in adolescents is unknown, and the clinical course and prognosis is still questioned. Recent research indicates that abnormalities of autonomic cardiovascular control may play an important role. The aim of this research project was to perform a follow-up study of adolescents with chronic fatigue syndrome, focusing on clinical symptoms and autonomic cardiovascular control. 47 adolescents (12-18 years old) with CFS were recruited from the outpatient clinic at the Department of Pediatrics, Oslo University Hospital. In a primary visit and a follow-up visit (3-17 months later), we evaluated: a) a wide range of complaints and symptoms and b) cardiovascular variables at baseline and during a 20° head-up tilt-test (HUT). At the second visit, patients reported significant improvement regarding functional impairments, fatigue severity, muscular pain, concentration problems, post-exertional malaise and the problem of non-relieving rest. Also, at the second visit, baseline heart rate (HR), blood pressure, total peripheral resistance index (TPRI) and LF/HF (low-frequency:high-frequency heart rate variability ratio, an index of sinus node sympathovagal balance derived from spectral analyses of heart rate) were significant lower, and the increases in HR, mean blood pressure (MBP), diastolic blood pressure (DBP) and TPRI during tilt were significantly less pronounced as compared to the first visit. There was a significant correlation between changes in autonomic symptom score, fatigue severity score and functional impairment score from the first to the second visit. The majority of adolescents with CFS experienced an improvement over time in functional impairment, self-reported fatigue and additional symptoms, and a concurrent improvement of autonomic cardiovascular control. A possible connection between clinical symptoms and abnormal autonomic control in CFS might represent a focus for further research.

  17. Adolescent chronic fatigue syndrome; a follow-up study displays concurrent improvement of circulatory abnormalities and clinical symptoms

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    Sulheim Dag

    2012-03-01

    Full Text Available Abstract Background The pathophysiology of chronic fatigue syndrome (CFS in adolescents is unknown, and the clinical course and prognosis is still questioned. Recent research indicates that abnormalities of autonomic cardiovascular control may play an important role. The aim of this research project was to perform a follow-up study of adolescents with chronic fatigue syndrome, focusing on clinical symptoms and autonomic cardiovascular control. Methods 47 adolescents (12-18 years old with CFS were recruited from the outpatient clinic at the Department of Pediatrics, Oslo University Hospital. In a primary visit and a follow-up visit (3-17 months later, we evaluated: a a wide range of complaints and symptoms and b cardiovascular variables at baseline and during a 20° head-up tilt-test (HUT. Results At the second visit, patients reported significant improvement regarding functional impairments, fatigue severity, muscular pain, concentration problems, post-exertional malaise and the problem of non-relieving rest. Also, at the second visit, baseline heart rate (HR, blood pressure, total peripheral resistance index (TPRI and LF/HF (low-frequency:high-frequency heart rate variability ratio, an index of sinus node sympathovagal balance derived from spectral analyses of heart rate were significant lower, and the increases in HR, mean blood pressure (MBP, diastolic blood pressure (DBP and TPRI during tilt were significantly less pronounced as compared to the first visit. There was a significant correlation between changes in autonomic symptom score, fatigue severity score and functional impairment score from the first to the second visit. Conclusions The majority of adolescents with CFS experienced an improvement over time in functional impairment, self-reported fatigue and additional symptoms, and a concurrent improvement of autonomic cardiovascular control. A possible connection between clinical symptoms and abnormal autonomic control in CFS might

  18. Cancer related fatigue syndrome in neoplastic diseases

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    Magdalena Franc

    2014-12-01

    Full Text Available Fatigue is one of the most important factors which has a considerable influence on treatment and the life quality of oncological patients. The fatigue syndrome is often diagnosed during cancer treatment and this syndrome is not related to the physical effort. Cancer related fatigue is a patient’s subjective, psychologically, physically and emotionally based feeling. It is disproportionate to patient’s daily activity. The pathogenesis of this syndrome remains still unknown. However, on the basis of various questionnaires, it is possible to test the disease’s complex nature. Cancer related fatigue causes deterioration of patient’s life along with lower motivation to struggle with the disease. It is thought that the factor which increases the incidence of cancer related fatigue is a long-term use of drugs such as opioids, benzodiazepine, and medicines containing codeine, tranquilizers, anxiolytics and antidepressants. On the basis of the results, one can choose an appropriate treatment method for cancer related fatigue such as rehabilitation, psychotherapy or public assistance. A great number of patients consider excessive fatigue a typical concomitant symptom in neoplastic disease; therefore, they do not report it. It is of a paramount importance to make patients aware of the fact that cancer related fatigue is a serious disease which can be treated.

  19. The challenge of integrating disparate high-content data: epidemiological, clinical and laboratory data collected during an in-hospital study of chronic fatigue syndrome.

    Science.gov (United States)

    Vernon, Suzanne D; Reeves, William C

    2006-04-01

    Chronic fatigue syndrome (CFS) is a debilitating illness characterized by multiple unexplained symptoms including fatigue, cognitive impairment and pain. People with CFS have no characteristic physical signs or diagnostic laboratory abnormalities, and the etiology and pathophysiology remain unknown. CFS represents a complex illness that includes alterations in homeostatic systems, involves multiple body systems and results from the combined action of many genes, environmental factors and risk-conferring behavior. In order to achieve understanding of complex illnesses, such as CFS, studies must collect relevant epidemiological, clinical and laboratory data and then integrate, analyze and interpret the information so as to obtain meaningful clinical and biological insight. This issue of Pharmacogenomics represents such an approach to CFS. Data was collected during a 2-day in-hospital study of persons with CFS, other medically and psychiatrically unexplained fatiguing illnesses and nonfatigued controls identified from the general population of Wichita, KS, USA. While in the hospital, the participants' psychiatric status, sleep characteristics and cognitive functioning was evaluated, and biological samples were collected to measure neuroendocrine status, autonomic nervous system function, systemic cytokines and peripheral blood gene expression. The data generated from these assessments was made available to a multidisciplinary group of 20 investigators from around the world who were challenged with revealing new insight and algorithms for integration of this complex, high-content data and, if possible, identifying molecular markers and elucidating pathophysiology of chronic fatigue. The group was divided into four teams with representation from the disciplines of medicine, mathematics, biology, engineering and computer science. The papers in this issue are the culmination of this 6-month challenge, and demonstrate that data integration and multidisciplinary

  20. Fear of movement and avoidance behaviour toward physical activity in chronic-fatigue syndrome and fibromyalgia: state of the art and implications for clinical practice.

    Science.gov (United States)

    Nijs, Jo; Roussel, Nathalie; Van Oosterwijck, Jessica; De Kooning, Margot; Ickmans, Kelly; Struyf, Filip; Meeus, Mira; Lundberg, Mari

    2013-08-01

    Severe exacerbation of symptoms following physical activity is characteristic for chronic-fatigue syndrome (CFS) and fibromyalgia (FM). These exacerbations make it understandable for people with CFS and FM to develop fear of performing body movement or physical activity and consequently avoidance behaviour toward physical activity. The aims of this article were to review what measures are available for measuring fear of movement and avoidance behaviour, the prevalence fear of movement and avoidance behaviour toward physical activity and the therapeutic options with fear of movement and avoidance behaviour toward physical activity in patients with CFS and FM. The review revealed that fear of movement and avoidance behaviour toward physical activity is highly prevalent in both the CFS and FM population, and it is related to various clinical characteristics of CFS and FM, including symptom severity and self-reported quality of life and disability. It appears to be crucial for treatment (success) to identify CFS and FM patients displaying fear of movement and avoidance behaviour toward physical activity. Individually tailored cognitive behavioural therapy plus exercise training, depending on the patient's classification as avoiding or persisting, appears to be the most promising strategy for treating fear of movement and avoidance behaviour toward physical activity in patients with CFS and FM.

  1. Living with ME/CFS. challenge for scientists?

    Science.gov (United States)

    Weiler, John J A

    2015-01-01

    A Graded Exercise Therapy (GET) - Myalgic Encephalomyelitis (ME)/Chronic Fatigue Syndrome (CFS) Running Anomaly. Imagine you have been disabled with ME/CFS's cluster of symptoms for 19 years. Yet, this morning you just ran an easy 10K with no flare up of your exercise intolerance symptoms during the run or post-exertional malaise after the run. Then later in the day you go browsing for books and after 30 minutes or so your exercise intolerance and post-exertional malaise symptoms flare up. You experience a wave of exhaustion, achy muscles and additional cognitive fog, all of which carry into the next day. To me, this is a confusing anomaly that needs an explanation.

  2. Metabolic profiling of a myalgic encephalomyelitis/chronic fatigue syndrome discovery cohort reveals disturbances in fatty acid and lipid metabolism.

    Science.gov (United States)

    Germain, Arnaud; Ruppert, David; Levine, Susan M; Hanson, Maureen R

    2017-01-31

    Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) remains a continuum spectrum disease without biomarkers or simple objective tests, and therefore relies on a diagnosis from a set of symptoms to link the assortment of brain and body disorders to ME/CFS. Although recent studies show various affected pathways, the underlying basis of ME/CFS has yet to be established. In this pilot study, we compare plasma metabolic signatures in a discovery cohort, 17 patients and 15 matched controls, and explore potential metabolic perturbations as the aftermath of the complex interactions between genes, transcripts and proteins. This approach to examine the complex array of symptoms and underlying foundation of ME/CFS revealed 74 differentially accumulating metabolites, out of 361 (P metabolism and glycerophospholipid metabolism, combined with primary bile acid metabolism, as well as glyoxylate and dicarboxylate metabolism and a few other pathways, all involved broadly in fatty acid metabolism. Purines, including ADP and ATP, pyrimidines and several amino acid metabolic pathways were found to be significantly disturbed. Finally, glucose and oxaloacetate were two main metabolites affected that have a major effect on sugar and energy levels. Our work provides a prospective path for diagnosis and understanding of the underlying mechanisms of ME/CFS.

  3. CFS in Children and Adolescent: Ten Years of Retrospective Clinical Evaluation

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    Irene Elgen

    2013-01-01

    Full Text Available Aim. To estimate number of children being diagnosed with chronic fatigue syndrome (CFS. Methods. For a period of 10 years (2002–2011 data from children being referred for fatigue symptoms were collected retrospectively. Results. Thirty-seven children were referred. Four were excluded due to incorrect coding. Six (18% patients received other diagnoses at the end of evaluation time. Of the 27 who received the diagnosis G93.3, four had a previous chronic illness, while 23 patients were previously healthy. All patients reported onset of fatigue symptom in relation to an infection, and all tested positive for IgG to either Epstein-Barr virus, cytomegalovirus or borrelia, indicating previous infection. There were 16 (59% boys among the 27 patients. The mean age at the debut of fatigue symptoms was 141 months (SD 30 for boys and 136 months (SD 31 for girls, respectively. Being underweight, defined as BMI < 17.5, was found in 12 (44% patients. Conclusion. An increasing number of children and adolescents are evaluated for CFS. The clinical assessment of children and adolescents with possible CFS need systematically evaluation. Nutritional status, possible eating disorder, and psychosocial issues need to be addressed and evaluated carefully. A multidisciplinary approach is essential when assessing CFS in children and adolescents. There is a need for European guidelines.

  4. The Terapeutic Effects of Electrical Acupuncture and Auricular-Plaster in 32 Cases of Chronic Fatigue Syndrome

    Institute of Scientific and Technical Information of China (English)

    Li Yuemei; Liu Hongping; Feng Shulan; Gong Dongfang

    2006-01-01

    Objective:To observe the therapeutic effects of electrical acupuncture and auricular-plaster therapy for chronic fatigue syndrome(CFS).Method:64 CFS patients were randomly divided into two groups.32 cases in the treatment group were treated by the electrical acupuncture and auricular-plaster therapy,and 32 cases in the control group with oral hydrocortisone.Results:The total effective rates were respectively 93.75% in the treatment group and 75.00% in the control group,with a statistically significant difference between the two groups(P<0.05).Conclusion:Electrical acupuncture and auricular-plaster therapy may show a better anti-fatigue effect than that of routine Western drugs.

  5. Clinical assessment of the physical activity pattern of chronic fatigue syndrome patients: a validation of three methods

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    Meer van der Jos

    2009-04-01

    Full Text Available Abstract Background Effective treatment of chronic fatigue syndrome (CFS with cognitive behavioural therapy (CBT relies on a correct classification of so called 'fluctuating active' versus 'passive' patients. For successful treatment with CBT is it especially important to recognise the passive patients and give them a tailored treatment protocol. In the present study it was evaluated whether CFS patient's physical activity pattern can be assessed most accurately with the 'Activity Pattern Interview' (API, the International Physical Activity Questionnaire (IPAQ or the CFS-Activity Questionnaire (CFS-AQ. Methods The three instruments were validated compared to actometers. Actometers are until now the best and most objective instrument to measure physical activity, but they are too expensive and time consuming for most clinical practice settings. In total 226 CFS patients enrolled for CBT therapy answered the API at intake and filled in the two questionnaires. Directly after intake they wore the actometer for two weeks. Based on receiver operating characteristic (ROC curves the validity of the three methods were assessed and compared. Results Both the API and the two questionnaires had an acceptable validity (0.64 to 0.71. None of the three instruments was significantly better than the others. The proportion of false predictions was rather high for all three instrument. The IPAQ had the highest proportion of correct passive predictions (sensitivity 70.1%. Conclusion The validity of all three instruments appeared to be fair, and all showed rather high proportions of false classifications. Hence in fact none of the tested instruments could really be called satisfactory. Because the IPAQ showed to be the best in correctly predicting 'passive' CFS patients, which is most essentially related to treatment results, it was concluded that the IPAQ is the preferable alternative for an actometer when treating CFS patients in clinical practice.

  6. A train-the-trainer education and promotion program: chronic fatigue syndrome – a diagnostic and management challenge

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    Hynes Kevin

    2008-10-01

    Full Text Available Abstract Background Chronic fatigue syndrome (CFS is a complicated illness for providers and patients. Fewer than 20% of persons with CFS have been diagnosed and treated. For providers, compounding the issue are the challenges in making a diagnosis due to the lack of a biomedical marker. Methods The objective of the CFS diagnosis and management curriculum was to instruct core trainers as to the evaluation, diagnosis, and management of CFS. Over a two year period, 79 primary care physicians, physician assistants, and nurse practitioners from diverse regions in the U.S. participated as core trainers in a two day Train-the-Trainer (TTT workshop. As core trainers, the workshop participants were expected to show increases in knowledge, self-efficacy, and management skills with the primary goal of conducting secondary presentations. Results The optimal goal for each core trainer to present secondary training to 50 persons in the health care field was not reached. However, the combined core trainer group successfully reached 2064 primary care providers. Eighty-two percent of core trainers responded "Very good" or "Excellent" in a post-tessurvey of self-efficacy expectation and CFS diagnosis. Data from the Chicago workshops showed significant improvement on the Primary Care Opinion Survey (p Conclusion Data show the workshop was successful in meeting the objectives of increasing CFS knowledge and raising perceived self-efficacy towards making a diagnosis. The CFS TTT program informed an educational provider project by shifting the format for physicians to grand rounds and continuing medical education design while retaining TTT aspects for nurse practitioners and physicians assistants. Evaluations also indicate that secondary trainings may be more readily employed and accepted if administrative barriers are addressed early in the planning phases.

  7. Severe fatigue in adolescents : psychological, neuro-endocrine, and immunological characteristics

    NARCIS (Netherlands)

    Wolbeek, M. ter

    2007-01-01

    Fatigue is a common complaint among adolescents. In a pilot study, we observed 8% of healthy adolescents to report fatigue severity which was comparable to fatigue severity reported by chronic fatigue syndrome (CFS) patients. This observation led to an extensive investigation on psychological, neuro

  8. Predictors of outcome in fatigued employees on sick leave: results from a randomised trial.

    NARCIS (Netherlands)

    Huibers, M.J.H.; Bleijenberg, G.; Amelsvoort, L.G. van; Beurskens, A.J.H.M.; Schayck, C.P. van; Bazelmans, E.; Knottnerus, J.A.

    2004-01-01

    OBJECTIVE: The main objective of this study was to identify predictors of fatigue caseness, work resumption and chronic fatigue syndrome (CFS)-like caseness in a sample of fatigued employees on sick leave. METHODS: For 12 months, 151 fatigued employees on sick leave, 44% of whom met research criteri

  9. The effect of fatigue and fibromyalgia on sexual dysfunction in women with chronic fatigue syndrome.

    Science.gov (United States)

    Blazquez, Alicia; Ruiz, Eva; Aliste, Luisa; García-Quintana, Ana; Alegre, José

    2015-01-01

    Sexual dysfunction in patients with chronic fatigue syndrome is attracting growing interest but, to date, few studies have analyzed it. For this reason, the authors evaluated sexual dysfunction in women with chronic fatigue syndrome (using the Golombok Rust Inventory of Sexual Satisfaction) and explore correlations with fatigue and other symptoms. Sexual dysfunction was greater in patients with chronic fatigue syndrome (n = 615) with a higher number of cognitive, neurological, and neurovegetative symptoms, concomitant fibromyalgia, Sjögren's syndrome, or myofascial pain syndrome, and more intense fatigue (p <.05).

  10. Genetic variation in catechol-O-methyltransferase modifies effects of clonidine treatment in chronic fatigue syndrome.

    Science.gov (United States)

    Hall, K T; Kossowsky, J; Oberlander, T F; Kaptchuk, T J; Saul, J P; Wyller, V B; Fagermoen, E; Sulheim, D; Gjerstad, J; Winger, A; Mukamal, K J

    2016-10-01

    Clonidine, an α2-adrenergic receptor agonist, decreases circulating norepinephrine and epinephrine, attenuating sympathetic activity. Although catechol-O-methyltransferase (COMT) metabolizes catecholamines, main effectors of sympathetic function, COMT genetic variation effects on clonidine treatment are unknown. Chronic fatigue syndrome (CFS) is hypothesized to result in part from dysregulated sympathetic function. A candidate gene analysis of COMT rs4680 effects on clinical outcomes in the Norwegian Study of Chronic Fatigue Syndrome in Adolescents: Pathophysiology and Intervention Trial (NorCAPITAL), a randomized double-blinded clonidine versus placebo trial, was conducted (N=104). Patients homozygous for rs4680 high-activity allele randomized to clonidine took 2500 fewer steps compared with placebo (Pinteraction=0.04). There were no differences between clonidine and placebo among patients with COMT low-activity alleles. Similar gene-drug interactions were observed for sleep (Pinteraction=0.003) and quality of life (Pinteraction=0.018). Detrimental effects of clonidine in the subset of CFS patients homozygous for COMT high-activity allele warrant investigation of potential clonidine-COMT interaction effects in other conditions.

  11. Heart rate variability during sleep and subsequent sleepiness in patients with chronic fatigue syndrome.

    Science.gov (United States)

    Togo, Fumiharu; Natelson, Benjamin H

    2013-06-01

    We determined whether alterations in heart rate dynamics during sleep in patients with chronic fatigue syndrome (CFS) differed from controls and/or correlated with changes of sleepiness before and after a night in the sleep laboratory. We compared beat-to-beat RR intervals (RRI) during nocturnal sleep, sleep structure, and subjective scores on visual analog scale for sleepiness in 18 CFS patients with 19 healthy controls aged 25-55 after excluding subjects with sleep disorders. A short-term fractal scaling exponent (α1) of RRI dynamics, analyzed by the detrended fluctuation analysis (DFA) method, was assessed after stratifying patients into those who reported more or less sleepiness after the night's sleep (a.m. sleepier or a.m. less sleepy, respectively). Patients in the a.m. sleepier group showed significantly (psleep (Stages 1, 2, and 3 sleep) than healthy controls, although standard polysomnographic measures did not differ between the groups. The fractal scaling index α1 during non-REM sleep was significantly (psleep onset for healthy controls and patients in the a.m. less sleepy group, but did not differ between sleep stages for patients in the a.m. sleepier group. For patients, changes in self-reported sleepiness before and after the night correlated positively with the fractal scaling index α1 during non-REM sleep (psleep might be associated with disrupted sleep in patients with CFS.

  12. Neuromuscular strain as a contributor to cognitive and other symptoms in chronic fatigue syndrome: hypothesis and conceptual model.

    Science.gov (United States)

    Rowe, Peter C; Fontaine, Kevin R; Violand, Richard L

    2013-01-01

    Individuals with chronic fatigue syndrome (CFS) have heightened sensitivity and increased symptoms following various physiologic challenges, such as orthostatic stress, physical exercise, and cognitive challenges. Similar heightened sensitivity to the same stressors in fibromyalgia (FM) has led investigators to propose that these findings reflect a state of central sensitivity. A large body of evidence supports the concept of central sensitivity in FM. A more modest literature provides partial support for this model in CFS, particularly with regard to pain. Nonetheless, fatigue and cognitive dysfunction have not been explained by the central sensitivity data thus far. Peripheral factors have attracted attention recently as contributors to central sensitivity. Work by Brieg, Sunderland, and others has emphasized the ability of the nervous system to undergo accommodative changes in length in response to the range of limb and trunk movements carried out during daily activity. If that ability to elongate is impaired-due to movement restrictions in tissues adjacent to nerves, or due to swelling or adhesions within the nerve itself-the result is an increase in mechanical tension within the nerve. This adverse neural tension, also termed neurodynamic dysfunction, is thought to contribute to pain and other symptoms through a variety of mechanisms. These include mechanical sensitization and altered nociceptive signaling, altered proprioception, adverse patterns of muscle recruitment and force of muscle contraction, reduced intra-neural blood flow, and release of inflammatory neuropeptides. Because it is not possible to differentiate completely between adverse neural tension and strain in muscles, fascia, and other soft tissues, we use the more general term "neuromuscular strain." In our clinical work, we have found that neuromuscular restrictions are common in CFS, and that many symptoms of CFS can be reproduced by selectively adding neuromuscular strain during the

  13. From Body to Mind and Spirit: Qigong Exercise for Bereaved Persons with Chronic Fatigue Syndrome-Like Illness

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    Jie Li

    2015-01-01

    Full Text Available Bereavement may bring negative impacts on the mind, body, and spiritual well-being of grieving persons. Some bereaved persons with chronic fatigue syndrome- (CFS- illness experience a dual burden of distress. This study investigated the effects of bereavement on CFS-like illness by comparing bereaved and nonbereaved participants. It also adopted a random group design to investigate the effectiveness of Qigong on improving the well-being of bereaved participants. The Qigong intervention comprised 10 group sessions delivered twice a week for 5 weeks and home-practice for at least three times a week lasting 15–30 minutes each. The participants’ fatigue, anxiety, and depression, quality of life (QoL, and spiritual well-being were measured at baseline and 3 months after treatment. The bereaved participants experienced significantly greater mental fatigue (16.09 versus 14.44, p=0.017 and lower physical QoL (34.02 versus 37.17, p=0.011 than their nonbereaved counterparts. After 3 months, the mental fatigue (−8 versus −4, p=0.010 and physical fatigue (−10 versus −5, p=0.007 experienced by intervention group had declined significantly, and improvements on their spirituality (14 versus −2, p=0.013 and psychological QoL (8.91 versus 0.69, p=0.002 scores exceeded those of the control group.

  14. Compassion Fatigue, Burnout, and Neonatal Abstinence Syndrome.

    Science.gov (United States)

    Sweigart, Erin

    2017-01-01

    NICU nurses have seen a dramatic increase in cases of neonatal abstinence syndrome (NAS). The care needs of infants with NAS are highly demanding and can lead to feelings of frustration and emotional exhaustion among NICU nurses. Although studies have examined the experiences of nurses caring for NAS patients, none have specifically addressed the risk for compassion fatigue and burnout. Nurses need practical strategies to reduce their risk for compassion fatigue and burnout when caring for these patients. Improved education and implementation of self-care measures can help nurses more effectively manage stress and positively impact care of these infants and their families.

  15. Dynamics of sleep stage transitions in healthy humans and patients with chronic fatigue syndrome.

    Science.gov (United States)

    Kishi, Akifumi; Struzik, Zbigniew R; Natelson, Benjamin H; Togo, Fumiharu; Yamamoto, Yoshiharu

    2008-06-01

    Physiological and/or pathological implications of the dynamics of sleep stage transitions have not, to date, been investigated. We report detailed duration and transition statistics between sleep stages in healthy subjects and in others with chronic fatigue syndrome (CFS); in addition, we also compare our data with previously published results for rats. Twenty-two healthy females and 22 female patients with CFS, characterized by complaints of unrefreshing sleep, underwent one night of polysomnographic recording. We find that duration of deep sleep (stages III and IV) follows a power-law probability distribution function; in contrast, stage II sleep durations follow a stretched exponential and stage I, and REM sleep durations follow an exponential function. These stage duration distributions show a gradually increasing departure from the exponential form with increasing depth of sleep toward a power-law type distribution for deep sleep, suggesting increasing complexity of regulation of deeper sleep stages. We also find a substantial number of REM to non-REM sleep transitions in humans, while this transition is reported to be virtually nonexistent in rats. The relative frequency of this REM to non-REM sleep transition is significantly lower in CFS patients than in controls, resulting in a significantly greater relative transition frequency of moving from both REM and stage I sleep to awake. Such an alteration in the transition pattern suggests that the normal continuation of sleep in light or REM sleep is disrupted in CFS. We conclude that dynamic transition analysis of sleep stages is useful for elucidating yet-to-be-determined human sleep regulation mechanisms with pathophysiological implications.

  16. High cocoa polyphenol rich chocolate may reduce the burden of the symptoms in chronic fatigue syndrome

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    Mellor Duane D

    2010-11-01

    Full Text Available Abstract Background Chocolate is rich in flavonoids that have been shown to be of benefit in disparate conditions including cardiovascular disease and cancer. The effect of polyphenol rich chocolate in subjects with chronic fatigue syndrome (CFS has not been studied previously. Methods We conducted a double blinded, randomised, clinical pilot crossover study comparing high cocoa liquor/polyphenol rich chocolate (HCL/PR in comparison to simulated iso-calorific chocolate (cocoa liquor free/low polyphenols(CLF/LP on fatigue and residual function in subjects with chronic fatigue syndrome. Subjects with CFS having severe fatigue of at least 10 out of 11 on the Chalder Fatigue Scale were enrolled. Subjects had either 8 weeks of intervention in the form of HCL/PR or CLF/LP, with a 2 week wash out period followed by 8 weeks of intervention with the other chocolate. Results Ten subjects were enrolled in the study. The Chalder Fatigue Scale score improved significantly after 8 weeks of the HCL/PR chocolate arm [median (range Exact Sig. (2-tailed] [33 (25 - 38 vs. 21.5 (6 - 35 0.01], but that deteriorated significantly when subjects were given simulated iso-calorific chocolate (CLF/CP [ 28.5 (17 - 20 vs. 34.5 (13-26 0.03]. The residual function, as assessed by the London Handicap scale, also improved significantly after the HCL/PR arm [0.49 (0.33 - 0.62 vs. 0.64 (0.44 - 0.83 0.01] and deteriorated after iso-calorific chocolate [00.44 (0.43 - 0.68 vs. 0.36 (0.33 - 0.620.03]. Likewise the Hospital Anxiety and Depression score also improved after the HCL/PR arm, but deteriorated after CLF/CP. Mean weight remained unchanged throughout the trial. Conclusion This study suggests that HCL/PR chocolate may improve symptoms in subjects with chronic fatigue syndrome.

  17. Why did I get chronic fatigue syndrome? A qualitative interview study of causal attributions in women patients.

    Science.gov (United States)

    Soderlund, Atle; Malterud, Kirsti

    2005-12-01

    To explore causal attributions among women with chronic fatigue syndrome (CFS). Qualitative study where data from individual semi-structured interviews were analysed according to Malterud's systematic text condensation. Bergen, Norway. A purposeful sample of eight women aged 25-55, recruited among members of a self-help organization. Accounts of causal attribution for CFS among the informants, focusing on gender. The participants agreed that their way of living could have increased the vulnerability of their resistance resources. Pressure they put upon themselves, workload burdens without subsequent relaxation, emotional conflicts, or preparing for assumed problem-solving were mentioned as gendered dimensions. They presented different explanations regarding potential triggers encountering their fragile immune systems, most often a virus infection. The participants thought women might have a weaker immune system than men, or that CFS was caused by a virus that women are more likely to catch. In their experience, their symptoms were activated when people put pressure on them, such that they might be nervous as to whether they could live up to the demands of their surroundings, and in the case of emotional strain related to family and work. More studies are needed exploring hypotheses concerning the complex interplay between molecular predispositions and more or less gendered lifestyle issues in CFS. Doctors need to challenge their strong beliefs regarding medically unexplained conditions, where facts still remain unresolved. Recognizing this, the doctor may provide realistic support and advice, and contribute to the establishment of common ground for understanding and managing the condition.

  18. Evidence of inflammatory immune signaling in chronic fatigue syndrome: A pilot study of gene expression in peripheral blood

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    Vernon Suzanne D

    2008-09-01

    Full Text Available Abstract Background Genomic profiling of peripheral blood reveals altered immunity in chronic fatigue syndrome (CFS however interpretation remains challenging without immune demographic context. The object of this work is to identify modulation of specific immune functional components and restructuring of co-expression networks characteristic of CFS using the quantitative genomics of peripheral blood. Methods Gene sets were constructed a priori for CD4+ T cells, CD8+ T cells, CD19+ B cells, CD14+ monocytes and CD16+ neutrophils from published data. A group of 111 women were classified using empiric case definition (U.S. Centers for Disease Control and Prevention and unsupervised latent cluster analysis (LCA. Microarray profiles of peripheral blood were analyzed for expression of leukocyte-specific gene sets and characteristic changes in co-expression identified from topological evaluation of linear correlation networks. Results Median expression for a set of 6 genes preferentially up-regulated in CD19+ B cells was significantly lower in CFS (p = 0.01 due mainly to PTPRK and TSPAN3 expression. Although no other gene set was differentially expressed at p Conclusion Dissection of blood microarray profiles points to B cell dysfunction with coordinated immune activation supporting persistent inflammation and antibody-mediated NK cell modulation of T cell activity. This has clinical implications as the CD19+ genes identified could provide robust and biologically meaningful basis for the early detection and unambiguous phenotyping of CFS.

  19. Abortive lytic Epstein–Barr virus replication in tonsil-B lymphocytes in infectious mononucleosis and a subset of the chronic fatigue syndrome

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    Lerner AM

    2012-11-01

    Full Text Available A Martin Lerner,1 Safedin Beqaj21Department of Medicine, Oakland University William Beaumont School of Medicine, Rochester, MI, USA; 2Pathology Inc, Torrance, CA, USAAbstract: A systematic 2001–2007 review of 142 chronic fatigue syndrome (CFS patients identified 106 CFS patients with elevated serum IgG antibodies to the herpesviruses Epstein–Barr virus (EBV, cytomegalovirus, or human herpesvirus (HHV 6 in single or multiple infections, with no other co-infections detected. We named these 106 patients group-A CFS. Eighty-six of these 106 group-A CFS patients (81% had elevated EBV early antibody, early antigen (diffuse, serum titers. A small group of six patients in the group-A EBV subset of CFS, additionally, had repetitive elevated-serum titers of antibody to the early lytic replication-encoded proteins, EBV dUTPase, and EBV DNA polymerase. The presence of these serum antibodies to EBV dUTPase and EBV DNA polymerase indicated EBV abortive lytic replication in these 6 CFS patients. None of 20 random control people (age- and sex-matched, with blood drawn at a commercial laboratory had elevated serum titers of antibody to EBV dUTPase or EBV DNA polymerase (P < 0.01. This finding needs verification in a larger group of EBV CFS subset patients, but if corroborated, it may represent a molecular marker for diagnosing the EBV subset of CFS. We review evidence that EBV abortive lytic replication with unassembled viral proteins in the blood may be the same in infectious mononucleosis (IM and a subset of CFS. EBV-abortive lytic replication in tonsil plasma cells is dominant in IM. No complete lytic virion is in the blood of IM or CFS patients. Complications of CFS and IM include cardiomyopathy and encephalopathy. Circulating abortive lytic-encoded EBV proteins (eg, EBV dUTPase, EBV DNA polymerase, and others may be common to IM and CFS. The intensity and duration of the circulating EBV-encoded proteins might differentiate the IM and EBV subsets of CFS

  20. Neurocognitive impairment in childhood chronic fatigue syndrome

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    Kei eMizuno

    2013-04-01

    Full Text Available Neurocognitive impairment is a feature of childhood chronic fatigue syndrome (CCFS. Several studies have demonstrated reduced attention control in CCFS patients in switching and divided attention tasks. In students, the extent of deterioration in task performance depends on the level of fatigue. Poor performance in switching and divided attention is common in both fatigued students and CCFS patients. Additionally, attentional functions show dramatic development from childhood to adolescence, suggesting that abnormal development of switching and divided attention may be induced by chronic fatigue. The brain structures associated with attentional control are situated in the frontal and parietal cortices, which are the last to mature, suggesting that severe fatigue in CCFS patients and students may inhibit normal structural and functional development in these regions. A combination of treatment with cognitive behavioral therapy and antidepressant medication is effective to improve attentional control processing in CCFS patients. Studies identifying the features of neurocognitive impairment in CCFS have improved our current understanding of the neurophysiological mechanisms of CCFS.

  1. Mechanisms underlying fatigue: a voxel-based morphometric study of chronic fatigue syndrome

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    Watanabe Yasuyoshi

    2004-10-01

    Full Text Available Abstract Background Fatigue is a crucial sensation that triggers rest, yet its underlying neuronal mechanisms remain unclear. Intense long-term fatigue is a symptom of chronic fatigue syndrome, which is used as a model to study the mechanisms underlying fatigue. Methods Using magnetic resonance imaging, we conducted voxel-based morphometry of 16 patients and 49 age-matched healthy control subjects. Results We found that patients with chronic fatigue syndrome had reduced gray-matter volume in the bilateral prefrontal cortex. Within these areas, the volume reduction in the right prefrontal cortex paralleled the severity of the fatigue of the subjects. Conclusion These results are consistent with previous reports of an abnormal distribution of acetyl-L-carnitine uptake, which is one of the biochemical markers of chronic fatigue syndrome, in the prefrontal cortex. Thus, the prefrontal cortex might be an important element of the neural system that regulates sensations of fatigue.

  2. Benefit from B-lymphocyte depletion using the anti-CD20 antibody rituximab in chronic fatigue syndrome. A double-blind and placebo-controlled study.

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    Øystein Fluge

    Full Text Available BACKGROUND: Chronic fatigue syndrome (CFS is a disease of unknown aetiology. Major CFS symptom relief during cancer chemotherapy in a patient with synchronous CFS and lymphoma spurred a pilot study of B-lymphocyte depletion using the anti-CD20 antibody Rituximab, which demonstrated significant clinical response in three CFS patients. METHODS AND FINDINGS: In this double-blind, placebo-controlled phase II study (NCT00848692, 30 CFS patients were randomised to either Rituximab 500 mg/m(2 or saline, given twice two weeks apart, with follow-up for 12 months. Xenotropic murine leukemia virus-related virus (XMRV was not detected in any of the patients. The responses generally affected all CFS symptoms. Major or moderate overall response, defined as lasting improvements in self-reported Fatigue score during follow-up, was seen in 10 out of 15 patients (67% in the Rituximab group and in two out of 15 patients (13% in the Placebo group (p = 0.003. Mean response duration within the follow-up period for the 10 responders to Rituximab was 25 weeks (range 8-44. Four Rituximab patients had clinical response durations past the study period. General linear models for repeated measures of Fatigue scores during follow-up showed a significant interaction between time and intervention group (p = 0.018 for self-reported, and p = 0.024 for physician-assessed, with differences between the Rituximab and Placebo groups between 6-10 months after intervention. The primary end-point, defined as effect on self-reported Fatigue score 3 months after intervention, was negative. There were no serious adverse events. Two patients in the Rituximab group with pre-existing psoriasis experienced moderate psoriasis worsening. CONCLUSION: The delayed responses starting from 2-7 months after Rituximab treatment, in spite of rapid B-cell depletion, suggests that CFS is an autoimmune disease and may be consistent with the gradual elimination of autoantibodies preceding

  3. Fibromyalgia, chronic fatigue syndrome, and myofascial pain syndrome.

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    Buskila, D

    2000-03-01

    Fibromyalgia and widespread pain were common in Gulf War veterans with unexplained illness referred to a rheumatology clinic. Increased tenderness was demonstrated in the postmenstrual phase of the cycle compared with the intermenstrual phase in normally cycling women but not in users of oral contraceptives. Patients with fibromyalgia had high levels of symptoms that have been used to define silicone implant-associated syndrome. Tender points were found to be a common transient finding associated with acute infectious mononucleosis, but fibromyalgia was an unusual long-term outcome. The common association of fibromyalgia with other rheumatic and systemic illnesses was further explored. A preliminary study revealed a possible linkage of fibromyalgia to the HLA region. Patients with fibromyalgia were found to have an impaired ability to activate the hypothalamic pituitary portion of the hypothalamic pituitary adrenal axis as well as the sympathoadrenal system, leading to reduced corticotropin and epinephrine response to hypoglycemia. Much interest has been expressed in the literature on the possible role of autonomic dysfunction in the development or exacerbation of fatigue and other symptoms in chronic fatigue syndrome. Mycoplasma genus and mycoplasma fermentans were detected by polymerase chain reaction in patients with chronic fatigue syndrome. It was reported that myofascial temporomandibular disorder does not run in families. No major therapeutic trials in fibromyalgia, chronic fatigue syndrome, or myofascial pain syndrome were reported over the past year. The effectiveness of cognitive behavioral therapy and behavior therapy for chronic pain in adults was emphasized. A favorable outcome of fibromyalgia and chronic fatigue syndrome in children and adolescents was reported.

  4. Fibromyalgia, chronic fatigue syndrome, and myofascial pain.

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    Bennett, R

    1998-03-01

    Epidemiologic studies continue to provide evidence that fibromyalgia is part of a spectrum of chronic widespread pain. The prevalence of chronic widespread pain is several times higher than fibromyalgia as defined by the 1990 American College of Rheumatology guidelines. There is now compelling evidence of a familial clustering of fibromyalgia cases in female sufferers; whether this clustering results from nature or nature remains to be elucidated. A wide spectrum of fibromyalgia-associated symptomatology and syndromes continues to be described. During the past year the association with interstitial cystitis has been explored, and neurally mediated hypotension has been documented in both fibromyalgia and chronic fatigue syndrome. Abnormalities of the growth hormone-insulin-like growth factor-1 axis have been also documented in both fibromyalgia and chronic fatigue syndrome. The commonly reported but anecdotal association of fibromyalgia with whiplash-type neck trauma was validated in a report from Israel. However, unlike North America, 100% of Israeli patients with posttraumatic fibromyalgia returned to work. Basic research in fibromyalgia continues to pinpoint abnormal sensory processing as being integral to understanding fibromyalgia pain. Drugs such as ketamine, which block N-methyl-D-aspartate receptors (which are often upregulated in central pain states) were shown to benefit fibromyalgia pain in an experimental setting. The combination of fluoxetine and amitriptyline was reported to be more beneficial than either drug alone in patients with fibromyalgia. A high prevalence of autoantibodies to cytoskeletal and nuclear envelope proteins was found in chronic fatigue syndrome, and an increased prevalence of antipolymer antibodies was found in symptomatic silicone breast implant recipients who often have fibromyalgia.

  5. EFFECTS OF GC-MACROPHAGE ACTIVATING FACTOR IN HUMAN NEURONS; IMPLICATIONS FOR TREATMENT OF CHRONIC FATIGUE SYNDROME

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    Rodney Smith

    2013-01-01

    Full Text Available Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS is a debilitating disease of multifactorial aetiology characterized by immune system dysfunction, widespread inflammation, multisystemic neuropathology and persistent pain. Given the central role of the immune system in the pathogenesis of the syndrome, we studied the effects of a potent modulator of the immune system in in vitro and in vivo models that could help clarifying its role and indications in ME/CFS treatment. To this end, we studied the effects of vitamin D-binding protein-derived macrophage activating factor (also designated as Gc-Macrophage Activating Factor or (GcMAF on human neuronal cells (SH-SY5Y and on the persistent pain induced by osteoarticular damage in rats. GcMAF at pM concentration increased neuronal cell viability and metabolism through increased mitochondrial enzyme activity. These effects were accompanied by cAMP formation and by morphological changes that were representative of neuronal differentiation. We hypothesize that these effects are to be ascribed to the interconnection between the GcMAF and Vitamin D Receptor (VDR signalling pathways. The results presented here confirm at the experimental level the therapeutic effects of GcMAF in ME/CFS and elucidate the mechanisms of action through which GcMAF might be responsible for such therapeutic effects.

  6. A Study of the Protective Effect of Triticum aestivum L. in an Experimental Animal Model of Chronic Fatigue Syndrome

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    Mukundam Borah

    2014-01-01

    Full Text Available Background: Oxidative stress plays a major role in the pathogenesis of chronic fatigue syndrome (CFS. Keeping in view the proven antioxidant activity of Triticum aestivum L., this study has been undertaken to explore the potential therapeutic benefit of this plant in the treatment of CFS. Objective: To study the protective effect of the ethanolic extract of the leaves of Triticum aestivum (EETA in an experimental mice model of CFS. Materials and Methods: Five groups of albino mice (20-25 g were selected for the study, with five animals in each group. Group A served as the naïve control and Group B served as the stressed control. Groups C and D received EETA (100 mg/kg and 200 mg/kg b.w.. Group E received imipramine (20 mg/kg b.w.. Except for Group A, mice in each group were forced to swim 6 min each for 7 days to induce a state of chronic fatigue. Duration of immobility was measured on every alternate day. After 7 days, various behavioral tests (mirror chamber and elevated plus maize test for anxiety, open field test for locomotor activity and biochemical estimations (malondialdehyde [MDA] and catalase activity in mice brain were performed. Results: Forced swimming in the stressed group resulted in a significant increase in immobility period, decrease in locomotor activity and elevated anxiety level. The brain homogenate showed significantly increased MDA and decreased catalase levels. The extract-treated groups showed significantly (P < 0.05 improved locomotor activity, decreased anxiety level, elevated catalase levels and reduction of MDA. Conclusion: The study confirms the protective effects of EETA in CFS.

  7. Neuromuscular strain as a contributor to cognitive and other symptoms in Chronic Fatigue Syndrome: Hypothesis and conceptual model.

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    Peter C. Rowe

    2013-05-01

    Full Text Available Individuals with chronic fatigue syndrome (CFS have heightened sensitivity and increased symptoms following various physiologic challenges, such as orthostatic stress, physical exercise, and cognitive challenges. Similar heightened sensitivity to the same stressors in fibromyalgia (FM has led investigators to propose that these findings reflect a state of central sensitivity. A large body of evidence supports the concept of central sensitivity in FM. A more modest literature provides partial support for this model in CFS, particularly with regard to pain. Nonetheless, fatigue and cognitive dysfunction have not been explained by the central sensitivity data thus far. Peripheral factors have attracted attention recently as contributors to central sensitivity. Work by Brieg, Sunderland, and others has emphasized the ability of the nervous system to undergo accommodative changes in length in response to the range of limb and trunk movements carried out during daily activity. If that ability to elongate is impaired—due to movement restrictions in tissues adjacent to nerves, or due to swelling or adhesions within the nerve itself—the result is an increase in mechanical tension within the nerve. This adverse neural tension, also termed neurodynamic dysfunction, is thought to contribute to pain and other symptoms through a variety of mechanisms. These include mechanical sensitization and altered nociceptive signaling, altered proprioception, adverse patterns of muscle recruitment and force of muscle contraction, reduced intra-neural blood flow, and release of inflammatory neuropeptides. Because it is not possible to differentiate completely between adverse neural tension and strain in muscles, fascia, and other soft tissues, we use the more general term neuromuscular strain. In our clinical work, we have found that neuromuscular restrictions are common in CFS, and that many symptoms of CFS can be reproduced by selectively adding neuromuscular strain

  8. Chronic fatigue syndrome: Harvey and Wessely's (biopsychosocial model versus a bio(psychosocial model based on inflammatory and oxidative and nitrosative stress pathways

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    Twisk Frank NM

    2010-06-01

    Full Text Available Abstract Background In a recently published paper, Harvey and Wessely put forward a 'biopsychosocial' explanatory model for myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS, which is proposed to be applicable to (chronic fatigue even when apparent medical causes are present. Methods Here, we review the model proposed by Harvey and Wessely, which is the rationale for behaviourally oriented interventions, such as cognitive behaviour therapy (CBT and graded exercise therapy (GET, and compare this model with a biological model, in which inflammatory, immune, oxidative and nitrosative (IO&NS pathways are key elements. Discussion Although human and animal studies have established that the pathophysiology of ME/CFS includes IO&NS pathways, these abnormalities are not included in the model proposed by Harvey and Wessely. Activation of IO&NS pathways is known to induce fatigue and somatic (F&S symptoms and can be induced or maintained by viral and bacterial infections, physical and psychosocial stressors, or organic disorders such as (autoimmune disorders. Studies have shown that ME/CFS and major depression are both clinical manifestations of shared IO&NS pathways, and that both disorders can be discriminated by specific symptoms and unshared or differentiating pathways. Interventions with CBT/GET are potentially harmful for many patients with ME/CFS, since the underlying pathophysiological abnormalities may be intensified by physical stressors. Conclusions In contrast to Harvey and Wessely's (biopsychosocial model for ME/CFS a bio(psychosocial model based upon IO&NS abnormalities is likely more appropriate to this complex disorder. In clinical practice, we suggest physicians should also explore the IO&NS pathophysiology by applying laboratory tests that examine the pathways involved.

  9. Social support needs for equity in health and social care: a thematic analysis of experiences of people with chronic fatigue syndrome/myalgic encephalomyelitis

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    de Carvalho Leite Jose C

    2011-11-01

    Full Text Available Abstract Background Needs-based resource allocation is fundamental to equitable care provision, which can meet the often-complex, fluctuating needs of people with Chronic Fatigue Syndrome/Myalgic Encephalomyelitis (CFS/ME. This has posed challenges both for those providing and those seeking support providers, in building shared understanding of the condition and of actions to address it. This qualitative study reports on needs for equity in health and social care expressed by adults living with CFS/ME. Methods The participants were 35 adults with CFS/ME in England, purposively selected to provide variation in clinical presentations, social backgrounds and illness experiences. Accounts of experienced needs and needs-related encounters with health and social services were obtained through a focus group (n = 6 and semi-structured interviews (n = 35. These were transcribed and needs related topics identified through data-led thematic analysis. Findings Participants emphasised needs for personalised, timely and sustained support to alleviate CFS/ME impacts and regain life control, in three thematic areas: (1 Illness symptoms, functional limitations and illness management; (2 practical support and social care; (3 financial support. Access of people with CFS/ME to support from health and social services was seen to be constrained by barriers stemming from social, cultural, organisational and professional norms and practices, further heightened for disadvantaged groups including some ethnic minorities. These reduced opportunities for their illness to be explained or associated functional limitations and social disadvantages to be addressed through social support. Participants sought more understanding of bio-psycho-social aspects of CFS/ME, of felt needs of people with CFS/ME and of human rights and disability rights, for providing person-centred, equitable care. Conclusions Changes in attitudes of health practitioners, policy makers and general public

  10. Economic evaluation of multidisciplinary rehabilitation treatment versus cognitive behavioural therapy for patients with chronic fatigue syndrome: A randomized controlled trial.

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    Vos-Vromans, Desirée; Evers, Silvia; Huijnen, Ivan; Köke, Albère; Hitters, Minou; Rijnders, Nieke; Pont, Menno; Knottnerus, André; Smeets, Rob

    2017-01-01

    A multi-centre RCT has shown that multidisciplinary rehabilitation treatment (MRT) is more effective in reducing fatigue over the long-term in comparison with cognitive behavioural therapy (CBT) for patients with chronic fatigue syndrome (CFS), but evidence on its cost-effectiveness is lacking. To compare the cost-effectiveness of MRT versus CBT for patients with CFS from a societal perspective. A multi-centre randomized controlled trial comparing MRT with CBT was conducted among 122 patients with CFS diagnosed using the 1994 criteria of the Centers for Disease Control and Prevention and aged between 18 and 60 years. The societal costs (healthcare costs, patient and family costs, and costs for loss of productivity), fatigue severity, quality of life, quality-adjusted life-year (QALY), and cost-effectiveness ratios (ICERs) were measured over a follow-up period of one year. The main outcome of the cost-effectiveness analysis was fatigue measured by the Checklist Individual Strength (CIS). The main outcome of the cost-utility analysis was the QALY based on the EuroQol-5D-3L utilities. Sensitivity analyses were performed, and uncertainty was calculated using the cost-effectiveness acceptability curves and cost-effectiveness planes. The data of 109 patients (57 MRT and 52 CBT) were analyzed. MRT was significantly more effective in reducing fatigue at 52 weeks. The mean difference in QALY between the treatments was not significant (0.09, 95% CI: -0.02 to 0.19). The total societal costs were significantly higher for patients allocated to MRT (a difference of €5,389, 95% CI: 2,488 to 8,091). MRT has a high probability of being the most cost effective, using fatigue as the primary outcome. The ICER is €856 per unit of the CIS fatigue subscale. The results of the cost-utility analysis, using the QALY, indicate that the CBT had a higher likelihood of being more cost-effective. The probability of being more cost-effective is higher for MRT when using fatigue as primary

  11. Vitamin and mineral status in chronic fatigue syndrome and fibromyalgia syndrome: A systematic review and meta-analysis.

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    Joustra, Monica L; Minovic, Isidor; Janssens, Karin A M; Bakker, Stephan J L; Rosmalen, Judith G M

    2017-01-01

    Many chronic fatigue syndrome (CFS) and fibromyalgia syndrome (FMS) patients (35-68%) use nutritional supplements, while it is unclear whether deficiencies in vitamins and minerals contribute to symptoms in these patients. Objectives were (1) to determine vitamin and mineral status in CFS and FMS patients as compared to healthy controls; (2) to investigate the association between vitamin and mineral status and clinical parameters, including symptom severity and quality of life; and (3) to determine the effect of supplementation on clinical parameters. The databases PubMed, EMBASE, Web of Knowledge, and PsycINFO were searched for eligible studies. Articles published from January 1st 1994 for CFS patients and 1990 for FMS patients till March 1st 2017 were included. Articles were included if the status of one or more vitamins or minerals were reported, or an intervention concerning vitamins or minerals was performed. Two reviewers independently extracted data and assessed the risk of bias. A total of 5 RCTs and 40 observational studies were included in the qualitative synthesis, of which 27 studies were included in the meta-analyses. Circulating concentrations of vitamin E were lower in patients compared to controls (pooled standardized mean difference (SMD): -1.57, 95%CI: -3.09, -0.05; p = .042). However, this difference was not present when restricting the analyses to the subgroup of studies with high quality scores. Poor study quality and a substantial heterogeneity in most studies was found. No vitamins or minerals have been repeatedly or consistently linked to clinical parameters. In addition, RCTs testing supplements containing these vitamins and/or minerals did not result in clinical improvements. Little evidence was found to support the hypothesis that vitamin and mineral deficiencies play a role in the pathophysiology of CFS and FMS, and that the use of supplements is effective in these patients. Study methods were documented in an international prospective

  12. Can the social model explain all of disability experience? Perspectives of persons with chronic fatigue syndrome.

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    Taylor, Renee R

    2005-01-01

    The social model of disability has had a major influence on the academic field of disability studies and on contemporary understandings of the causes and experience of disability. The purpose of this study was to examine the adequacy of the social model for explaining the disability experience of persons with chronic fatigue syndrome (CFS). This qualitative study examined the experiences of 47 adults with CFS participating in a research project that aimed to evaluate a participant-designed rehabilitation program. Data were aggregated from focus group interviews, open-ended questionnaires, progress notes, and from a program evaluation questionnaire. Data analysis was based on a grounded theory approach and used triangulation of multiple data sources and member checks to assure dependability of findings. Four themes emerged from the analysis: (1) minimization and mistrust of the disability; (2) negative experiences of impairment; (3) lack of identification with the disability community; and (4) the focus on advocacy as a quest for legitimacy. These themes varied in the extent to which they conformed to the principles set forth by the social model. Although the social model has important contributions to lend to occupational therapy practice, it is important to recognize that it may not capture the full reality of disability. In particular, the social model has serious limitations in describing the disability experience of individuals with disabilities who do not have visibly obvious disabilities and whose impairments do not conform to the traditional viewpoint of disability.

  13. Integrated Weighted Gene Co-expression Network Analysis with an Application to Chronic Fatigue Syndrome

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    Rajeevan Mangalathu S

    2008-11-01

    Full Text Available Abstract Background Systems biologic approaches such as Weighted Gene Co-expression Network Analysis (WGCNA can effectively integrate gene expression and trait data to identify pathways and candidate biomarkers. Here we show that the additional inclusion of genetic marker data allows one to characterize network relationships as causal or reactive in a chronic fatigue syndrome (CFS data set. Results We combine WGCNA with genetic marker data to identify a disease-related pathway and its causal drivers, an analysis which we refer to as "Integrated WGCNA" or IWGCNA. Specifically, we present the following IWGCNA approach: 1 construct a co-expression network, 2 identify trait-related modules within the network, 3 use a trait-related genetic marker to prioritize genes within the module, 4 apply an integrated gene screening strategy to identify candidate genes and 5 carry out causality testing to verify and/or prioritize results. By applying this strategy to a CFS data set consisting of microarray, SNP and clinical trait data, we identify a module of 299 highly correlated genes that is associated with CFS severity. Our integrated gene screening strategy results in 20 candidate genes. We show that our approach yields biologically interesting genes that function in the same pathway and are causal drivers for their parent module. We use a separate data set to replicate findings and use Ingenuity Pathways Analysis software to functionally annotate the candidate gene pathways. Conclusion We show how WGCNA can be combined with genetic marker data to identify disease-related pathways and the causal drivers within them. The systems genetics approach described here can easily be used to generate testable genetic hypotheses in other complex disease studies.

  14. Adolescent chronic fatigue syndrome and somatoform disorders: a prospective clinical study.

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    Klineberg, Emily; Rushworth, Alexandra; Bibby, Helen; Bennett, David; Steinbeck, Kate; Towns, Susan

    2014-10-01

    To examine and compare the presenting characteristics and the change in the physical and psychosocial functioning of adolescents with chronic fatigue syndrome (CFS) or somatoform disorders who have received an adaptable multidisciplinary intervention over a 12-month period. Fifty adolescents presenting to the Complex Adolescent Clinic at The Children's Hospital at Westmead, Sydney, Australia were assessed. Their physical and psychosocial functioning was rated by the adolescents and their parents using the Child Health Questionnaire. Participants were assessed at baseline, 4 months and 12 months after initiating treatment. Analyses examined whether diagnosis and/or illness precipitants were related to treatment outcome. Adolescents with both CFS and somatoform disorders demonstrated improvement in physical and psychosocial functioning over the first 4 months of treatment, sustained at 12-month follow-up. A diagnosis of CFS was associated with poorer physical functioning over time and a trend towards a longer illness time course compared with somatoform disorder. Adjustment for a physical precipitant reduced the association between diagnosis and physical functioning. Those who had a physical precipitant to their illness had significantly poorer physical functioning over time than those who did not, regardless of diagnostic category. Diagnosis and physical precipitant were not associated with psychosocial functioning. Improvement in adolescent physical and psychosocial functioning over time suggests that a multidisciplinary treatment model may be effective for varied complex medico-psychosocial presentations, irrespective of diagnosis and illness precipitant. Illness precipitant may have a greater influence on treatment outcome than diagnostic category. © 2014 The Authors. Journal of Paediatrics and Child Health © 2014 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

  15. [Chronic fatigue syndrome: immune dysfunction, role of pathogens and toxic agents and neurological and cardial changes].

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    Hilgers, A; Frank, J

    1994-01-01

    375 patients with chronic fatigue syndrome (CFS) were examined using a standardized questionnaire and subsequent interview on 11 risk factors and 45 symptoms. Additionally immunologic, serologic, toxicologic, neuroradiologic, neurophysiologic and cardiologic investigations were performed. Immunologic tests showed cellular immunodeficiences particularly in functional regard (pathological lymphocyte stimulation in 50% of the patients, disorders of granulocyte function in 44%). Furthermore variable deviations were found in the lymphocyte subpopulations (CD3, CD4, CD8, CD19, DR, Leu 11 + 19). In the humoral part tendencies to low IgG-3- and IgG-1-subclass-levels occurred (59% respectively 11% of the patients) also as decreases in complement system (CH50, C3, C4, C1-esterase-inhibitor). In the group of activation markers and cytokines 42% of the investigated patients had circulating immune complexes (CIC), 47% increases of tumor-necrosis-factor (TNF-a) and 21% increases of soluble interleukin-2-receptor (IL-2-R). The increased occurrence of autoantibodies in the CFS-patients (specially antinuclear anti-bodies [ANA], microsomal thyroid antibodies) suggest, that CFS is associated with or the beginning of manifest autoimmune disease. Under the pathogens 78% of the patients had a striking serological constellation of Epstein-Barr-Virus (EBV-EA positive, low EBNA-titers), in the HHV-6-Virus 47% showed increased antibody-titers. Tests on further herpes viruses and on Borreliae, Chlamydiae, Candida and Amoebae were positive in 8 to 36% of the examined patients. Furthermore there were found variable deficits of vitamins and trace elements also as hormonal disturbances.(ABSTRACT TRUNCATED AT 250 WORDS)

  16. Effects of the Intelligent-Turtle Massage on the Physical Symptoms and Immune Functions in Patients with Chronic Fatigue Syndrome

    Institute of Scientific and Technical Information of China (English)

    WANG Ji-hong; CHAI Tie-qu; LIN Guo-hua; LUO Lin

    2009-01-01

    To evaluate the effects of the intelligent-turtle massage on the physical symptoms and immune functions in patients with chronic fatigue syndrome (CFS). Methods: 182 cases of CFS were randomly divided into an experimental group of 91 cases treated by the intelligent-turtle massage,and a control group of 91 cases treated with the conventional massage method. After 2 courses of treatment,the therapeutic effects were statistically analyzed with the accumulated score for the improved clinical symptoms; and the changes of IgA,IgM and IgG were compared in 96 cases. Results: There was a significant difference between the two groups in the accumulated scores for improvement of the symptoms (P<0.05). A remarkable difference was found in the therapeutic effect. And there was a significant difference in the IgA,IgM and IgG levels between the two groups (P<0.05). Conclusion: The intelligent-turtle massage is an effective therapy for relieving the physical symptoms of CFS,and it may show certain effects on the immune functions.

  17. The impact of symptom stability on time frame and recall reliability in CFS

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    Meredyth Evans

    2015-12-01

    Full Text Available This study is an investigation of the potential impact of perceived symptom stability on the recall reliability of symptom severity and frequency as reported by individuals with chronic fatigue syndrome (CFS. Symptoms were recalled using three different recall time frames (the past week, the past month, and the past six months and at two assessment points (with one week in between each assessment. Participants were 51 adults (45 women and 6 men, between the ages of 29 and 66 with a current diagnosis of CFS. Multilevel Model Analyses were used to determine the optimal recall time frame (in terms of test–retest reliability for reporting symptoms perceived as variable and as stable over time. Headaches were recalled more reliably when they were reported as stable over time. Furthermore, the optimal time frame in terms of test–retest reliability for stable symptoms was highly uniform, such that all Fukuda CFS symptoms were more reliably recalled at the six-month time frame. Furthermore, the optimal time frame for CFS symptoms perceived as variable, differed across symptoms. Symptom stability and recall time frame are important to consider in order to improve the accuracy and reliability of the current methods for diagnosing this illness.

  18. Effects of early childhood trauma on hypothalamic-pituitary-adrenal (HPA) axis function in patients with Chronic Fatigue Syndrome.

    Science.gov (United States)

    Kempke, Stefan; Luyten, Patrick; De Coninck, Sarah; Van Houdenhove, Boudewijn; Mayes, Linda C; Claes, Stephan

    2015-02-01

    There is a paucity of studies that have investigated the assumption that early childhood trauma is associated with hypothalamic-pituitary-adrenal (HPA) axis dysfunction in Chronic Fatigue Syndrome (CFS). The current study is the first to simultaneously investigate relationships among early childhood trauma, cortisol activity, and cortisol stress reactivity to psychosocial stress in a sample of well-screened CFS patients. We also examined whether self-critical perfectionism (SCP) plays a mediating role in the potential relationship between early trauma and neurobiological stress responses. A total of 40 female patients diagnosed with CFS were asked to provide morning saliva cortisol samples (after awakening, 30min later, and 1h later) for seven consecutive days as a measure of cortisol activity. In addition, patients were exposed to the Trier Social Stress Test, a well-validated stress test, to investigate the relationship between early childhood trauma and cortisol stress reactivity. Before the start of the study, patients completed the Childhood Trauma Questionnaire-Short form (CTQ-SF) as a measure of early childhood trauma (i.e. sexual, physical and emotional traumatic experiences). SCP was measured with the Depressive Experiences Questionnaire (DEQ). Data were analyzed by calculating several indices of cortisol secretion (i.e. Cortisol Awakening Response and Area Under the Curve). There was no association between early childhood trauma and cortisol as measured over the 7-day period. However, emotional neglect was significantly negatively related to cortisol reactivity in the TSST. SCP did not significantly mediate this association. Findings of this study suggest that emotional neglect is associated with blunted HPA axis reactivity, congruent with the assumption that CFS may reflect loss of adaptability of the neuroendocrine stress response system in at least a subgroup of patients. Copyright © 2014 Elsevier Ltd. All rights reserved.

  19. Family-focused cognitive behaviour therapy versus psycho-education for chronic fatigue syndrome in 11- to 18-year-olds: a randomized controlled treatment trial.

    Science.gov (United States)

    Chalder, T; Deary, V; Husain, K; Walwyn, R

    2010-08-01

    Only one previous randomized controlled trial (RCT) has examined the efficacy of cognitive behaviour therapy (CBT) for chronic fatigue syndrome (CFS) in children. The aim of this study was to compare family-focused CBT with psycho-education for CFS in adolescents. Sixty-three 11- to 18-year-olds (43 girls, 20 boys) with CFS were randomly assigned to either family-focused CBT or psycho-education delivered over 6 months. School attendance was the main outcome, which was assessed at the end of treatment and at 3, 6 and 12 months follow-up. At the main outcome point (the 6-month follow-up) both groups had improved similarly. However, although those who received family-focused CBT were attending school for longer than those who received psycho-education, at discharge from treatment and at 3 months follow-up, they improved less quickly across the follow-up period. Adolescents with CFS get back to school more quickly after family-focused CBT. This is important as they are at a crucial stage of their development. However, the finding that psycho-education was as effective as family-focused CBT at 6 and 12 months follow-up has important implications for health service delivery.

  20. Blood Proteins Linked to Severity of Chronic Fatigue Syndrome

    Science.gov (United States)

    ... https://medlineplus.gov/news/fullstory_167505.html Blood Proteins Linked to Severity of Chronic Fatigue Syndrome Inflammation ... it to changes in 17 immune-system signaling proteins called cytokines. That suggests inflammation plays a part ...

  1. Regional distribution of fatiguing illnesses in the United States: a pilot study

    Science.gov (United States)

    Bierl, Cynthia; Nisenbaum, Rosane; Hoaglin, David C; Randall, Bonnie; Jones, Ann-Britt; Unger, Elizabeth R; Reeves, William C

    2004-01-01

    Background Chronic fatigue syndrome (CFS) is a debilitating illness with no known cause or effective therapy. Population-based epidemiologic data on CFS prevalence are critical to put CFS in a realistic context for public health officials and others responsible for allocating resources. Methods We conducted a pilot random-digit-dialing survey to estimate the prevalence of fatiguing illnesses in different geographic regions and in urban and rural populations of the United States. This report focuses on 884 of 7,317 respondents 18 to 69 years old. Fatigued (440) and randomly selected non-fatigued (444) respondents completed telephone questionnaires concerning fatigue, other symptoms, and medical history. Results We estimated 12,186 per 100,000 persons 18 to 69 years of age suffered from fatigue lasting for at least 6 months (chronic fatigue), and 1,197 per 100,000 described an illness that, though lacking clinical evaluation, met criteria for CFS (CFS-like). Chronic fatigue and CFS-like illness were more common in rural than in urban populations, although the differences were not significant. The prevalence of these fatiguing illnesses did not differ meaningfully among the four regions surveyed, and no significant geographic trends were observed. Conclusions This investigation estimated that nearly 2.2 million American adults suffer from CFS-like illness. The study also suggested the need to focus future investigations of fatigue on populations with lower incomes and less education. There was no evidence for regional differences in the occurrence of fatiguing illnesses. PMID:14761250

  2. Regional distribution of fatiguing illnesses in the United States: a pilot study

    Directory of Open Access Journals (Sweden)

    Unger Elizabeth R

    2004-02-01

    Full Text Available Abstract Background Chronic fatigue syndrome (CFS is a debilitating illness with no known cause or effective therapy. Population-based epidemiologic data on CFS prevalence are critical to put CFS in a realistic context for public health officials and others responsible for allocating resources. Methods We conducted a pilot random-digit-dialing survey to estimate the prevalence of fatiguing illnesses in different geographic regions and in urban and rural populations of the United States. This report focuses on 884 of 7,317 respondents 18 to 69 years old. Fatigued (440 and randomly selected non-fatigued (444 respondents completed telephone questionnaires concerning fatigue, other symptoms, and medical history. Results We estimated 12,186 per 100,000 persons 18 to 69 years of age suffered from fatigue lasting for at least 6 months (chronic fatigue, and 1,197 per 100,000 described an illness that, though lacking clinical evaluation, met criteria for CFS (CFS-like. Chronic fatigue and CFS-like illness were more common in rural than in urban populations, although the differences were not significant. The prevalence of these fatiguing illnesses did not differ meaningfully among the four regions surveyed, and no significant geographic trends were observed. Conclusions This investigation estimated that nearly 2.2 million American adults suffer from CFS-like illness. The study also suggested the need to focus future investigations of fatigue on populations with lower incomes and less education. There was no evidence for regional differences in the occurrence of fatiguing illnesses.

  3. Subgrouping Chronic Fatigue Syndrome Patients by Genetic and Immune Profiling

    Science.gov (United States)

    2014-10-01

    AWARD NUMBER: W81XWH-12-1-0388 TITLE: Subgrouping Chronic Fatigue Syndrome Patients by Genetic and Immune Profiling ...2014 4. TITLE AND SUBTITLE 5a. CONTRACT NUMBER Subgrouping Chronic Fatigue Syndrome Patients By Genetic And Immune Profiling 5b. GRANT...studying the results. We have finished the DNA isolation and anticipate the HLA testing to be completed this upcoming year. We want to interrogate the

  4. Characteristics of the Polysomnography of Chronic Fatigue Syndrome%慢性疲劳综合征的多导睡眠图特征

    Institute of Scientific and Technical Information of China (English)

    黄兵; 吴曦

    2012-01-01

    文章从睡眠参数变化的角度,对近年来公开发表的关于慢性疲劳综合征(CFS)多导睡眠图研究的文献进行分析,总结了CFS的多导睡眠图改变,并分析了变化的原因及与其他疾病的相关性,并指出了控制神经精神症状对于该病的重要性.%Depending on the changes of sleep parameters, this article analyzed literatures which published in recent years a-bout changes on the polysomnography of patients with Chronic Fatigue Syndrome, sumroerized the polysomnography changes, stated its reasons and corresponding diseases, and pointed out the importance of controlling neuropsychiatric symptoms of CFS.

  5. Intermittent and graded exercise effects on NK cell degranulation markers LAMP-1/LAMP-2 and CD8(+)CD38(+) in chronic fatigue syndrome/myalgic encephalomyelitis.

    Science.gov (United States)

    Broadbent, Suzanne; Coutts, Rosanne

    2017-03-01

    There is substantial evidence of immune system dysfunction in chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) but little is understood of exercise training effects on lymphocyte function in this illness. This study investigated whether graded and intermittent exercise improved CD8(+) lymphocyte activation and natural killer cell degranulation markers compared to no exercise. Twenty-four chronic fatigue syndrome (CFS) patients (50.2 ± 10 year) were randomized to graded exercise (GE), intermittent exercise (IE) or usual care (UC) groups; a control group (CTL) of 18 matched sedentary non-CFS/ME participants were included for immunological variable comparisons. Main outcome measures were pre- and postintervention expression of CD3(+)CD8(+)CD38(+) and CD3(-)CD16(+)56(+)CD107a(+) (LAMP-1) CD107b(+) (LAMP-2) and aerobic exercise capacity. The postintervention percentage of NK cells expressing LAMP-1 and -2 was significantly higher in IE compared to UC, and higher in GE compared to UC and CTL LAMP-1 and LAMP-2 expression (absolute numbers and percent positive) increased significantly pre-to-postintervention for both GE and IE Preintervention, the absolute number of CD8(+)CD38(+) cells was significantly lower in CTL compared to UC and IE There were no significant pre- to postintervention changes in CD8(+)CD38(+) expression for any group. Aerobic exercise capacity was significantly improved by GE and IE Twelve weeks of GE and IE increased the expression of NK cell activation and degranulation markers, suggesting enhanced immunosurveillance. Low-intensity exercise may also reduce CD8(+)CD38(+) expression, a marker of inflammation. Both GE and IE improved exercise capacity without worsening CFS/ME symptoms, and more robust trials of these exercise modalities are warranted.

  6. Fatigue in neuromuscular disorders: focus on Guillain–Barré syndrome and Pompe disease

    OpenAIRE

    2009-01-01

    textabstractFatigue accounts for an important part of the burden experienced by patients with neuromuscular disorders. Substantial high prevalence rates of fatigue are reported in a wide range of neuromuscular disorders, such as Guillain-Barré syndrome and Pompe disease. Fatigue can be subdivided into experienced fatigue and physiological fatigue. Physiological fatigue in turn can be of central or peripheral origin. Peripheral fatigue is an important contributor to fatigue in neuromuscular di...

  7. Evaluation of protective effect of Aegle marmelos Corr. in an animal model of chronic fatigue syndrome

    Directory of Open Access Journals (Sweden)

    Vanphawng Lalremruta

    2012-01-01

    Full Text Available Objective: To evaluate ethanolic extract of leaves of Aegle marmelos in an experimental animal model of chronic fatigue syndrome for potential therapeutic benefit. Materials and Methods: Age/weight-matched female Wistar albino rats were grouped into five groups. (Group I- V (n = 8. Group I served as naïve control and II served as stress control. Except for group I animals, other group animals were subjected to forced swimming every day for 15 minutes to induce a state of chronic fatigue and simultaneously treated with ethanolic extract of Aegle marmelos (EEAM 150 and 250 mg/kg b.w. and Imipramine (20 mg.kg b.w., respectively. Duration of immobility, anxiety level and locomotor activity were assessed on day 1, 7, 14 and 21 followed by biochemical estimation of oxidative biomarkers at the end of the study. Results: Treatment with EEAM (150 and 250 mg/kg b.w. resulted in a statistically significant and dose dependent reduction (P <0.001 in the duration of immobility, reduction in anxiety and increase in locomotor activity. Dose dependent and significant reduction in LPO level and increase in CAT and SOD was observed in extract treated animals. Conclusion: The results are suggestive of potential protective effect of A. marmelos against experimentally induced CFS.

  8. The Role of Autonomic Function in Exercise-induced Endogenous Analgesia: A Case-control Study in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome and Healthy People.

    Science.gov (United States)

    Oosterwijck, Jessica Van; Marusic, Uros; De Wandele, Inge; Paul, Lorna; Meeus, Mira; Moorkens, Greta; Lambrecht, Luc; Danneels, Lieven; Nijs, Jo

    2017-03-01

    Patients with myalgic encephalomyelitis / chronic fatigue syndrome (ME/CFS) are unable to activate brain-orchestrated endogenous analgesia (or descending inhibition) in response to exercise. This physiological impairment is currently regarded as one factor explaining post-exertional malaise in these patients. Autonomic dysfunction is also a feature of ME/CFS. This study aims to examine the role of the autonomic nervous system in exercise-induced analgesia in healthy people and those with ME/CFS, by studying the recovery of autonomic parameters following aerobic exercise and the relation to changes in self-reported pain intensity. A controlled experimental study. The study was conducted at the Human Physiology lab of a University. Twenty women with ME/CFS- and 20 healthy, sedentary controls performed a submaximal bicycle exercise test known as the Aerobic Power Index with continuous cardiorespiratory monitoring. Before and after the exercise, measures of autonomic function (i.e., heart rate variability, blood pressure, and respiration rate) were performed continuously for 10 minutes and self-reported pain levels were registered. The relation between autonomous parameters and self-reported pain parameters was examined using correlation analysis. Some relationships of moderate strength between autonomic and pain measures were found. The change (post-exercise minus pre-exercise score) in pain severity was correlated (r = .580, P = .007) with the change in diastolic blood pressure in the healthy group. In the ME/CFS group, positive correlations between the changes in pain severity and low frequency (r = .552, P = .014), and between the changes in bodily pain and diastolic blood pressure (r = .472, P = .036), were seen. In addition, in ME/CHFS the change in headache severity was inversely correlated (r = -.480, P = .038) with the change in high frequency heart rate variability. Based on the cross-sectional design of the study, no firm conclusions can be drawn on the

  9. Are chronic fatigue and chronic fatigue syndrome valid clinical entities across countries and health-care settings?

    NARCIS (Netherlands)

    Hickie, I.; Davenport, T.; Vernon, S.D.; Nisenbaum, R.; Reeves, W.C.; Hadzi-Pavlovic, D.; Lloyd, A.; Bleijenberg, G.; Werf, S.P. van der; Prins, J.B.; Blenkiron, P.M.; Buchwald, D.; Smith, W.R.; Edwards, R.; Lynch, S.; Kirmayer, L.J.; Taillefer, S.S.; Lee, S.; Martin, N.G.; Gillespie, N.E.; McIlvenny, S.; Sartorius, N.; Ustun, T.B.; Skapinakis, P.; Wessely, S.; Chalder, T.; Hotopf, M.; Nimnuan, C.; Candy, B.; Darbishire, L.; Ridsdale, L.; White, P.D.; Thomas, J.M.; Wilhelm, K.; Wilson, A.

    2009-01-01

    OBJECTIVE: The validity of the diagnosis of chronic fatigue syndrome and related chronic fatigue states remains controversial, particularly in psychiatry. This project utilized international epidemiological and clinical research data to test construct validity across diagnostic categories, health-ca

  10. Fatigue Status in Relation to Lifestyle in Healthy Japanese Adolescents

    Directory of Open Access Journals (Sweden)

    Ning Zou

    2010-01-01

    Full Text Available In order to investigate the prevalence of physical, mental, and chronic fatigue syndrome-(CFS- related fatigue and its relation to lifestyle, 1,225 adolescents (591 males, 634 females aged 11 to 16 years were asked to complete a self-reported questionnaire on fatigue status and lifestyle in the past one month. There was no gender difference in physical and mental fatigue scores, but CFS-related scores were significantly higher in females than in males. These scores were found to increase with the increase of age. After adjusting for age and gender, multiple regression analysis showed that physical and mental fatigue scores were associated with sleeping hours, extracurricular sports activity, food balance, the frequencies of snacks between regular meals, intake of sugar-sweetened beverages, and visits to the nurse's room. This paper is the first large cross-sectional study on fatigue in healthy adolescents in Japan, albeit there were numerous such studies in Western countries.

  11. Complementary and alternative medical therapy utilization by people with chronic fatiguing illnesses in the United States

    Directory of Open Access Journals (Sweden)

    Jones Ann-Britt

    2007-04-01

    Full Text Available Abstract Background Chronic fatiguing illnesses, including chronic fatigue syndrome (CFS, pose a diagnostic and therapeutic challenge. Previous clinical reports addressed the utilization of health care provided to patients with CFS by a variety of practitioners with other than allopathic training, but did not examine the spectrum of complementary and alternative medicine (CAM therapies used. This study was designed to measure CAM therapy use by persons with fatiguing illnesses in the United States population. Methods During a random-digit dialing survey to estimate the prevalence of CFS-like illness in urban and rural populations from different geographic regions of the United States, we queried the utilization of CAM including manipulation or body-based therapies, alternative medical systems, mind-body, biologically-based, and energy modalities. Results Four hundred forty fatigued and 444 non-fatigued persons from 2,728 households completed screening. Fatigued subjects included 53 persons with prolonged fatigue, 338 with chronic fatigue, and 49 with CFS-like illness. Mind-body therapy (primarily personal prayer and prayer by others was the most frequently used CAM across all groups. Among women, there was a significant trend of increasing overall CAM use across all subgroups (p-trend = 0.003. All categories of CAM use were associated with significantly poorer physical health scores, and all but one (alternative medicine systems were associated with significantly poorer mental health scores. People with CFS-like illness were significantly more likely to use body-based therapy (chiropractic and massage than non-fatigued participants (OR = 2.52, CI = 1.32, 4.82. Use of body-based therapies increased significantly in a linear trend across subgroups of non-fatigued, prolonged fatigued, chronic fatigued, and CFS-like subjects (p-trend = 0.002. People with chronic fatigue were also significantly more likely to use body-based therapy (OR = 1.52, CI = 1

  12. Chronic fatigue syndrome: diagnosis and treatment

    African Journals Online (AJOL)

    2011-08-11

    Aug 11, 2011 ... of treatment are shown to alter the condition's course. The ... physical exertion, and no restorative sleep. Fatigue may be ... not been shown to be casually related to any particular psychiatric disease. ... energy and decreased fatigue.23 Moderate aerobic exercise, ... Int Arch Occup Environ Health. 2006 ...

  13. Brain Dysfunction as One Cause of CFS Symptoms Including Difficulty with Attention and Concentration

    Directory of Open Access Journals (Sweden)

    Benjamin H Natelson

    2013-05-01

    Full Text Available We have been able to reduce substantially patient pool heterogeneity by identifying phenotypic markers that allow the researcher to stratify chronic fatigue syndrome (CFS patients into subgroups. To date, we have shown that stratifying based on the presence or absence of co-morbid psychiatric diagnosis leads to a group with evidence of neurological dysfunction across a number of spheres. We have also found that stratifying based on the presence or absence of comorbid fibromyalgia leads to information that would not have been found on analyzing the entire, unstratified patient group. Objective evidence of orthostatic intolerance may be another important variable for stratification and may define a group with episodic cerebral hypoxia leading to symptoms. We hope that this review will encourage other researchers to collect data on discrete phenotypes in CFS to allow this work to continue more broadly. Finding subgroups of CFS suggests different underlying pathophysiological processes responsible for the symptoms seen. Understanding those processes is the first step toward developing discrete treatments for each.

  14. A potential biomarker for fatigue: Oxidative stress and anti-oxidative activity.

    Science.gov (United States)

    Fukuda, Sanae; Nojima, Junzo; Motoki, Yukari; Yamaguti, Kouzi; Nakatomi, Yasuhito; Okawa, Naoko; Fujiwara, Kazumi; Watanabe, Yasuyoshi; Kuratsune, Hirohiko

    2016-07-01

    We sought to determine whether oxidative stress and anti-oxidative activity could act as biomarkers that discriminate patients with chronic fatigue syndrome (CFS) from healthy volunteers at acute and sub-acute fatigue and resting conditions. We calculated the oxidative stress index (OSI) from reactive oxygen metabolites-derived compounds (d-ROMs) and the biological antioxidant potential (BAP). We determined changes in d-ROMs, BAP, and OSI in acute and sub-acute fatigue in two healthy groups, and compared their values at rest between patients with CFS (diagnosed by Fukuda 1994 criteria) and another group of healthy controls. Following acute fatigue in healthy controls, d-ROMs and OSI increased, and BAP decreased. Although d-ROMs and OSI were significantly higher after sub-acute fatigue, BAP did not decrease. Resting condition yielded higher d-ROMs, higher OSI, and lower BAP in patients with CFS than in healthy volunteers, but lower d-ROMs and OSI when compared with sub-acute controls. BAP values did not significantly differ between patients with CFS and controls in the sub-acute condition. However, values were significantly higher than in the resting condition for controls. Thus, measured of oxidative stress (d-ROMS) and anti-oxidative activity (BAP) might be useful for discriminating acute, sub-acute, and resting fatigue in healthy people from patients with CFS, or for evaluating fatigue levels in healthy people.

  15. Treatment of Fatigue Syndrome by Tuina: A Report of 79 Cases

    Institute of Scientific and Technical Information of China (English)

    ZHANG Jia-fu; LIN Qiang; CUI Yi-jun

    2003-01-01

    Purpose To study the therapeutic methods of fatigue syndrome. Methods Seventy-nine cases of fatigue syndrome were treated by Tuina manipulation and a comprehensive assessment of main complaints and accompanied symptoms was made. Results After 3month's Tuina treatment, 21 cases were cured, 43 cases improved, 15 cases obtained no effects. Conclusion Tuina has a unique therapeutic effect on fatigue syndrome.

  16. Adiponectin Potentially Contributes to the Antidepressive Effects of Baduanjin Qigong Exercise in Women With Chronic Fatigue Syndrome-Like Illness.

    Science.gov (United States)

    Chan, Jessie S M; Li, Ang; Ng, Siu-Man; Ho, Rainbow T H; Xu, Aimin; Yao, Tzy-Jyun; Wang, Xiao-Min; So, Kwok-Fai; Chan, Cecilia L W

    2017-03-13

    Our recent study demonstrates that adiponectin signaling plays a significant role in mediating physical exercise-exerted effects on hippocampal neurogenesis and antidepression in mice. Whether the findings can be translated to humans remains unknown. This study aimed to investigate the effects of Baduanjin Qigong exercise on adiponectin and to evaluate whether adiponectin is involved in the antidepressive effects of Qigong exercise on chronic fatigue syndrome (CFS)-like illness. This is a randomized, waitlist-controlled trial. One hundred eight female participants were randomly assigned to either Qigong exercise or waitlist groups. Sixteen 1.5-h Qigong lessons were conducted. Outcome measures were taken at three time points. Baseline adiponectin levels were negatively associated with body weight, body mass index, waist circumference, hip circumference, and waist/hip ratio in women with CFS-like illness. Compared with the waitlist control, Qigong exercise significantly reduced anxiety and depression symptoms and significantly raised plasma adiponectin levels (median = 0.8 vs. -0.1, p Qigong exercise were associated with decreases in depression scores for the Qigong group (r = -0.38, p = 0.04). Moreover, adjusted linear regression analysis further identified Qigong exercise and change in adiponectin levels as the significant factors accounting for reduction of depression symptoms. Baduanjin Qigong significantly increased adiponectin levels in females with CFS-like illness. Decreases in depression symptoms were associated with increases in adiponectin levels following Qigong exercise, indicating that the potential contribution of adiponectin to Qigong exercise elicited antidepressive effects in human subjects.

  17. A role for homeostatic drive in the perpetuation of complex chronic illness: Gulf War Illness and chronic fatigue syndrome.

    Directory of Open Access Journals (Sweden)

    Travis J A Craddock

    Full Text Available A key component in the body's stress response, the hypothalamic-pituitary-adrenal (HPA axis orchestrates changes across a broad range of major biological systems. Its dysfunction has been associated with numerous chronic diseases including Gulf War Illness (GWI and chronic fatigue syndrome (CFS. Though tightly coupled with other components of endocrine and immune function, few models of HPA function account for these interactions. Here we extend conventional models of HPA function by including feed-forward and feedback interaction with sex hormone regulation and immune response. We use this multi-axis model to explore the role of homeostatic regulation in perpetuating chronic conditions, specifically GWI and CFS. An important obstacle in building these models across regulatory systems remains the scarcity of detailed human in vivo kinetic data as its collection can present significant health risks to subjects. We circumvented this using a discrete logic representation based solely on literature of physiological and biochemical connectivity to provide a qualitative description of system behavior. This connectivity model linked molecular variables across the HPA axis, hypothalamic-pituitary-gonadal (HPG axis in men and women, as well as a simple immune network. Inclusion of these interactions produced multiple alternate homeostatic states and sexually dimorphic responses. Experimental data for endocrine-immune markers measured in male GWI subjects showed the greatest alignment with predictions of a naturally occurring alternate steady state presenting with hypercortisolism, low testosterone and a shift towards a Th1 immune response. In female CFS subjects, expression of these markers aligned with an alternate homeostatic state displaying hypocortisolism, high estradiol, and a shift towards an anti-inflammatory Th2 activation. These results support a role for homeostatic drive in perpetuating dysfunctional cortisol levels through persistent

  18. [The non-specific environmental syndromes MCS (Multiple Chemical Sensitivity), IEI (Idiopathic Environmental Intolerance) and SBS (Sick Building Syndrome)].

    Science.gov (United States)

    Csef, H

    1998-11-30

    This review starts with a clinical description of the most common unspecific environmental diseases, such as Multiple Chemical Sensitivities (MCS), Idiopathic Environmental Intolerances (IEI) and Sick Building Syndrome (SBS). These syndromes are very controversial discussed between scientific medicine and "clinical ecology". In addition, they have fundamental similarities to Chronic Fatigue Syndrome (CFS) and Fibromyalgia. Finally the spectrum of therapeutic approaches is discussed.

  19. 'The letting go, the building up, [and] the gradual process of rebuilding': identity change and post-traumatic growth in myalgic encephalomyelitis/chronic fatigue syndrome.

    Science.gov (United States)

    Arroll, Megan A; Howard, Alex

    2013-01-01

    The aim of this study was to explore the phenomenon of identity change and subsequent post-traumatic growth (PTG) in individuals with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). Ten participants (average illness duration 7.4 years) were interviewed (average length, 79 minutes) via a semi-structured interview schedule and verbatim transcriptions were analysed with interpretative phenomenological analysis. The four superordinate themes revealed were 'comparisons of past to present self: "you have to be someone else, and you have to live with that''', 'the effect of social isolation on identity and subsequent insights into others' behaviours', 'contemplation of future and identity: ''where do I go from here?"', and 'PTG: "the letting go, the building up, [and] the gradual process of rebuilding"'. These themes outlined the experiences of those with ME/CFS as they underwent changes in identity due to the limitations the condition imposed on activities and roles, understanding others' behaviours after a period of isolation, the comparison of the past self with the present self and finally, the positive growth that was noted by two of the interviewees with regards to a new 'true' self. Despite the distressing and unpredictable nature of ME/CFS, it appears that individuals with this disorder can experience personal growth.

  20. The Relationship between Age and Illness Duration in Chronic Fatigue Syndrome

    Directory of Open Access Journals (Sweden)

    Elizabeth Kidd

    2016-04-01

    Full Text Available Chronic fatigue syndrome (CFS is a debilitating illness, but it is unclear if patient age and illness duration might affect symptoms and functioning of patients. In the current study, participants were categorized into four groups based upon age (under or over age 55 and illness duration (more or less than 10 years. The groups were compared on functioning and symptoms. Findings indicated that those who were older with a longer illness duration had significantly higher levels of mental health functioning than those who were younger with a shorter or longer illness duration and the older group with a shorter illness duration. The results suggest that older patients with an illness duration of over 10 years have significantly higher levels of mental health functioning than the three other groups. For symptoms, the younger/longer illness duration group had significantly worse immune and autonomic domains than the older/longer illness group. In addition, the younger patients with a longer illness duration displayed greater autonomic and immune symptoms in comparison to the older group with a longer illness duration. These findings suggest that both age and illness duration need to be considered when trying to understand the influence of these factors on patients.

  1. Prevalence of Chronic Fatigue Syndrome-Related Symptoms among Nurses.

    Science.gov (United States)

    Jason, Leonard A.; And Others

    1993-01-01

    The prevalence of chronic fatigue syndrome among 1,474 nurses was addressed through a mailed questionnaire (202 respondents). Demographic characteristics, symptoms, and possible prevalence rates are presented and discussed. Implications of these findings are considered, and the methodology used is analyzed. Suggestions are made for conducting…

  2. Genetics and Gene Expression Involving Stress and Distress Pathways in Fibromyalgia with and without Comorbid Chronic Fatigue Syndrome

    Directory of Open Access Journals (Sweden)

    Kathleen C. Light

    2012-01-01

    Full Text Available In complex multisymptom disorders like fibromyalgia syndrome (FMS and chronic fatigue syndrome (CFS that are defined primarily by subjective symptoms, genetic and gene expression profiles can provide very useful objective information. This paper summarizes research on genes that may be linked to increased susceptibility in developing and maintaining these disorders, and research on resting and stressor-evoked changes in leukocyte gene expression, highlighting physiological pathways linked to stress and distress. These include the adrenergic nervous system, the hypothalamic-pituitary-adrenal axis and serotonergic pathways, and exercise responsive metabolite-detecting ion channels. The findings to date provide some support for both inherited susceptibility and/or physiological dysregulation in all three systems, particularly for catechol-O-methyl transferase (COMT genes, the glucocorticoid and the related mineralocorticoid receptors (NR3C1, NR3C2, and the purinergic 2X4 (P2X4 ion channel involved as a sensory receptor for muscle pain and fatigue and also in upregulation of spinal microglia in chronic pain models. Methodological concerns for future research, including potential influences of comorbid clinical depression and antidepressants and other medications, on gene expression are also addressed.

  3. Exploring Chronic Fatigue Syndrome in Adolescents

    NARCIS (Netherlands)

    Putte, E.M. van de

    2006-01-01

    The research for this thesis has been conducted in three consecutive studies: Fatigue in Teenagers-I (FIT-I) in 2002, FIT-II in 2004 and FIT-III in 2006. In each FIT-study different research questions were formulated on the basis of the biopsychosocial model. The three FIT-studies resulted in the ch

  4. Participant attributions for global change ratings in unexplained chronic fatigue and chronic fatigue syndrome.

    Science.gov (United States)

    Friedberg, Fred; Coronel, Janna; Seva, Viktoria; Adamowicz, Jenna L; Napoli, Anthony

    2016-05-01

    The purpose of this mixed methods study was to identify participants' attributions for their global impression of change ratings in a behavioral intervention for unexplained chronic fatigue and chronic fatigue syndrome. At 3-month follow-up, participants (N = 67) were asked "Why do you think you are (improved, unchanged, worse)?" Improved patients pointed to specific behavioral changes, unchanged patients referred to a lack of change in lifestyle, and worsened patients invoked stress and/or specific life events. Identifying patient perceptions of behaviors associated with patient global impression of change-rated improvement and non-improvement may assist in developing more effective management strategies in clinical care.

  5. Levels of DHEA and DHEAS and responses to CRH stimulation and hydrocortisone treatment in chronic fatigue syndrome.

    Science.gov (United States)

    Cleare, A J; O'Keane, V; Miell, J P

    2004-07-01

    An association between chronic fatigue syndrome (CFS) and abnormalities of the hypothalamo-pituitary-adrenal axis has been described, and other adrenal steroid abnormalities have been suggested. Dehydroepiandrostenedione (DHEA) and its sulphate (DHEA-S), apart from being a precursor of sex steroids, have other functions associated with memory, depression and sleep. It has been suggested that CFS may be associated with a state of relative DHEA(-S) deficiency. Therefore we investigated basal levels of DHEA(-S), the cortisol/DHEA molar ratio and the responsiveness of DHEA to stimulation by corticotrophin-releasing hormone (CRH). Recent studies have also suggested that low dose hydrocortisone may be effective at reducing fatigue in CFS. We therefore also assessed these parameters prior to and following treatment with low dose oral hydrocortisone. Basal levels of serum DHEA, DHEAS and cortisol were measured in 16 patients with CFS without depression and in 16 controls matched for age, gender, weight, body mass index and menstrual history. CRH tests (1 g/kg i.v.) were carried out on all subjects and DHEA measured at 0, +30 and +90 min. In the patient group, CRH tests were repeated on two further occasions following treatment with hydrocortisone (5 or 10 mg, p.o.) or placebo for 1 month each in a double-blind cross over study protocol. Basal levels of DHEA were higher in the patient, compared to the control, group (14.1+/-2.2 vs. 9.0+/-0.90 ng/ml, P=0.04), while levels of DHEAS in patients (288.7+/-35.4 microg/dl) were not different from controls (293.7+/-53.8, P=NS). Higher DHEA levels were correlated with higher disability scores. Basal cortisol levels were higher in patients, and consequently the cortisol/DHEA molar ratio did not differ between patients and controls. Levels of DHEA (8.9+/-0.97 ng/ml, P=0.015) and DHEAS (233.4+/-41.6 microg/dl, P=0.03) were lower in patients following treatment with hydrocortisone. There was a rise in DHEA responsiveness to CRH in the

  6. Chronic fatigue syndrome: acute infection and history of physical activity affect resting levels and response to exercise of plasma oxidant/antioxidant status and heat shock proteins.

    Science.gov (United States)

    Jammes, Y; Steinberg, J G; Delliaux, S

    2012-07-01

    A history of high-level physical activity and/or acute infection might constitute stress factors affecting the plasma oxidant-antioxidant status and levels of heat shock proteins (HSPs) in patients with chronic fatigue syndrome (CFS). This case-control study compared data from 43 CFS patients to results from a matched control group of 23 healthy sedentary subjects. Five patients had no relevant previous history (group I). Eighteen had practised high-level sport (group II), and severe acute infection had been diagnosed in nine patients (group III). A combination of sport practice and infection was noted in 11 patients (group IV). After examination at rest, all subjects performed a maximal cycling exercise test. Plasma levels of two markers of oxidative stress [thiobarbituric acid reactive substances (TBARS) and reduced ascorbic acid (RAA)] and both HSP27 and HSP70 were measured. At rest, compared with the control group, the TBARS level was higher in groups II, III and IV patients, and the RAA level was lower in groups III and IV. In addition, HSP70 levels were significantly lower in all CFS groups, compared with controls, but negative correlations were found between resting HSP27 and HSP70 levels and the history of physical activity. After exercise, the peak level of TBARS significantly increased in groups II, III and IV, and the variations in HSP27 and HSP70 were attenuated or suppressed, with the greatest effects in groups III and IV. The presence of stress factors in the history of CFS patients is associated with severe oxidative stress and the suppression of protective HSP27 and HSP70 responses to exercise. © 2011 The Association for the Publication of the Journal of Internal Medicine.

  7. 中医五音疗法在慢性疲劳综合征患者中的应用%Effect of TCM five-tone therapy on chronic fatigue syndrome

    Institute of Scientific and Technical Information of China (English)

    吴玉娟; 郑盛惠; 吴杰倩; 贾院春; 席蓉; 胡秋侠; 姜健

    2013-01-01

    目的:观察中医五音疗法对慢性疲劳综合征(chronic fatigue syndrome,CFS)患者的影响。方法将CFS患者分为治疗组30例和对照组29例。治疗组治疗采.用中医五音疗法,对照组采.用普通音乐疗法,连续治疗3个月。采.用疲劳量表(fatigue scale-14,FS-14)、抑郁状态问卷(depression status inventory,DSI)及疼痛视觉模拟量表(visual analogue scale,VAS)对患者进行测评。结果治疗后,治疗组患者FS-14、DSI及VAS得分均低于对照组(均P<0.05)。结论中医五音疗法可降低CFS患者疲劳程度和抑郁情绪及缓解患者疼痛的程度。%Objective To study the effect of TCM five-tone therapy on chronic fatigue syndrome(CFS).Methods Fifty nine CFS patients were divided into the treatment group(n=30)and the control group(n=29),which received TCM five-tone therapy and common music therapy,respectively for 3 months.Both groups were assessed with fatigue Scale-14,depression status inventory and visual analogue scale.Result After treatment,the treatment group was scored lower than the control group in FS-14,DSI and VAS(all P<0.05).Conclusion TCM five-tone therapy may be more effective in decreasing the CFS patients with fatigue and depression and alleviating their pain symptoms.

  8. Incidence of irritable bowel syndrome and chronic fatigue following GI infection: a population-level study using routinely collected claims data.

    Science.gov (United States)

    Donnachie, Ewan; Schneider, Antonius; Mehring, Michael; Enck, Paul

    2017-06-10

    To investigate the occurrence of postinfectious IBS in routine outpatient care, comparing different types of GI infection and its interaction with psychosomatic comorbidity. Retrospective cohort study using routinely collected claims data covering statutorily insured patients in Bavaria, Germany. Cases were defined as patients without prior record of functional intestinal disorder with a first-time diagnosis of GI infection between January 2005 and December 2013 and classed according to the type of infection. Each case was matched by age, sex and district of residence to a patient without history of GI infection. Prior psychological disorder (depression, anxiety or stress reaction disorder) was assessed in the 2 years prior to inclusion. Proportional hazards regression models were used to estimate the HRs for GI infection and psychological disorder. Chronic fatigue syndrome (CFS) was assessed as a comparator outcome. A total of 508 278 patients with first diagnosis of GI infection were identified, resulting in a matched cohort of 1 016 556 patients. All infection types were associated with an increased risk of IBS (HR: 2.19-4.25) and CFS (HR 1.35-1.82). Prior psychological disorder was a distinct risk factor for IBS (HR: 1.73) and CFS (HR: 2.08). Female sex was a further risk factor for both conditions. Psychological disorder and GI infections are distinct risk factors for IBS. The high incidence of non-specific GI infection suggests that postinfectious IBS is a common clinical occurrence in primary care. Chronic fatigue is a further significant sequela of GI infection. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  9. A Pair of Identical Twins Discordant for Myalgic Encephalomyelitis/Chronic Fatigue Syndrome Differ in Physiological Parameters and Gut Microbiome Composition

    Science.gov (United States)

    Giloteaux, Ludovic; Hanson, Maureen R.; Keller, Betsy A.

    2016-01-01

    Patient: Male, 34 Final Diagnosis: ME/CFS Symptoms: Exertion intolerance • loss of functional capacity • pain • severe fatigue Medication: — Clinical Procedure: Cardiopulmonary exercise test Specialty: Sports Medicine Objective: Unknown ethiology Background: Patients with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) present with profound fatigue, flu-like symptoms, pain, cognitive impairment, orthostatic intolerance, post-exertional malaise (PEM), and exacerbation of some or all of the baseline symptoms. Case Report: We report on a pair of 34-year-old monozygotic twins discordant for ME/CFS, with WELL, the non-affected twin, and ILL, the affected twin. Both twins performed a two-day cardiopulmonary exercise test (CPET), preand post-exercise blood samples were drawn, and both provided stool samples for biochemical and molecular analyses. At peak exertion for both CPETs, ILL presented lower VO2peak and peak workload compared to WELL. WELL demonstrated normal reproducibility of VO2@ventilatory/anaerobic threshold (VAT) during CPET2, whereas ILL experienced an abnormal reduction of 13% in VAT during CPET2. A normal rise in lactate dehydrogenase (LDH), creatine kinase (CK), adrenocorticotropic hormone (ACTH), cortisol, creatinine, and ferritin content was observed following exercise for both WELL and ILL at each CPET. ILL showed higher increases of resistin, soluble CD40 ligand (sCD40L), and soluble Fas ligand (sFasL) after exercise compared to WELL. The gut bacterial microbiome and virome were examined and revealed a lower microbial diversity in ILL compared to WELL, with fewer beneficial bacteria such as Faecalibacterium and Bifidobacterium, and an expansion of bacteriophages belonging to the tailed dsDNA Caudovirales order. Conclusions: Results suggest dysfunctional immune activation in ILL following exercise and that prokaryotic viruses may contribute to mucosal inflammation and bacterial dysbiosis. Therefore, a two-day CPET and molecular

  10. Natural killer cells and single nucleotide polymorphisms of specific ion channels and receptor genes in myalgic encephalomyelitis/chronic fatigue syndrome

    Directory of Open Access Journals (Sweden)

    Marshall-Gradisnik S

    2016-03-01

    Full Text Available Sonya Marshall-Gradisnik,1,2 Teilah Huth,1,2 Anu Chacko,1,2 Samantha Johnston,1,2 Pete Smith,2 Donald Staines21School of Medical Science, 2National Centre for Neuroimmunology and Emerging Diseases, Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD, Australia Aim: The aim of this paper was to determine natural killer (NK cytotoxic activity and if single nucleotide polymorphisms (SNPs and genotypes in transient receptor potential (TRP ion channels and acetylcholine receptors (AChRs were present in isolated NK cells from previously identified myalgic encephalomyelitis (ME/chronic fatigue syndrome (CFS patients. Subjects and methods: A total of 39 ME/CFS patients (51.69±2 years old and 30 unfatigued controls (47.60±2.39 years old were included in this study. Patients were defined according to the 1994 Centers for Disease Control and Prevention criteria. Flow cytometry protocols were used to examine NK cytotoxic activity. A total of 678 SNPs from isolated NK cells were examined for 21 mammalian TRP ion channel genes and for nine mammalian AChR genes via the Agena Bioscience iPlex Gold assay. SNP association and genotype was determined using analysis of variance and Plink software. Results: ME/CFS patients had a significant reduction in NK percentage lysis of target cells (17%±4.68% compared with the unfatigued control group (31%±6.78%. Of the 678 SNPs examined, eleven SNPs for TRP ion channel genes (TRPC4, TRPC2, TRPM3, and TRPM8 were identified in the ME/CFS group. Five of these SNPs were associated with TRPM3, while the remainder were associated with TRPM8, TRPC2, and TRPC4 (P<0.05. Fourteen SNPs were associated with nicotinic and muscarinic AChR genes: six with CHRNA3, while the remainder were associated with CHRNA2, CHRNB4, CHRNA5, and CHRNE (P<0.05. There were sixteen genotypes identified from SNPs in TRP ion channels and AChRs for TRPM3 (n=5, TRPM8 (n=2, TRPC4 (n=3, TRPC2 (n=1, CHRNE (n=1, CHRNA2 (n=2, CHRNA3 (n=1

  11. Interstitial Cystitis/Painful Bladder Syndrome and Associated Medical Conditions With an Emphasis on Irritable Bowel Syndrome, Fibromyalgia and Chronic Fatigue Syndrome

    DEFF Research Database (Denmark)

    Nickel, J.C.; Tripp, D.A.; Pontari, M.;

    2010-01-01

    Purpose: We characterized and compared the impact of clinical phenotypic associations between interstitial cystitis/painful bladder syndrome and controls in relation to potentially related conditions, particularly irritable bowel syndrome, fibromyalgia and chronic fatigue syndrome. Materials and ...

  12. Beneficial Effect of Brewers' Yeast Extract on Daily Activity in a Murine Model of Chronic Fatigue Syndrome

    Directory of Open Access Journals (Sweden)

    Takashi Takahashi

    2006-01-01

    Full Text Available The aim of this study was to assess the effect of Brewers' yeast extract (BYE on daily activity in a mouse model of chronic fatigue syndrome (CFS. CFS was induced by repeated injection of Brucella abortus (BA antigen every 2 weeks. BYE was orally administered to mice in a dose of 2 g per kg per day for 2 weeks before injecting BA and for 4 weeks thereafter. We evaluated daily running activity in mice receiving BYE as compared with that in untreated mice. Weekly variation of body weight (BW and survival in both groups was monitored during the observation period. Spleen weight (SW, SW/BW ratio, percent splenic follicular area and expression levels of interferon-γ (IFN-γ and interleukin-10 (IL-10 mRNA in spleen were determined in both groups at the time of sacrifice. The daily activity during 2 weeks after the second BA injection was significantly higher in the treated group than in the control. There was no difference in BW between both groups through the experimental course. Two mice in the control died 2 and 7 days after the second injection, whereas no mice in the treated group died. Significantly decreased SW and SW/BW ratio were observed in the treated mice together with elevation of splenic follicular area. There were suppressed IFN-γ and IL-10 mRNA levels in spleens from the treated mice. Our results suggest that BYE might have a protective effect on the marked reduction in activity following repeated BA injection via normalization of host immune responses.

  13. Beneficial effect of brewers' yeast extract on daily activity in a murine model of chronic fatigue syndrome.

    Science.gov (United States)

    Takahashi, Takashi; Yu, Fei; Zhu, Shi-Jie; Moriya, Junji; Sumino, Hiroyuki; Morimoto, Shigeto; Yamaguchi, Nobuo; Kanda, Tsugiyasu

    2006-03-01

    The aim of this study was to assess the effect of Brewers' yeast extract (BYE) on daily activity in a mouse model of chronic fatigue syndrome (CFS). CFS was induced by repeated injection of Brucella abortus (BA) antigen every 2 weeks. BYE was orally administered to mice in a dose of 2 g per kg per day for 2 weeks before injecting BA and for 4 weeks thereafter. We evaluated daily running activity in mice receiving BYE as compared with that in untreated mice. Weekly variation of body weight (BW) and survival in both groups was monitored during the observation period. Spleen weight (SW), SW/BW ratio, percent splenic follicular area and expression levels of interferon-gamma (IFN-gamma) and interleukin-10 (IL-10) mRNA in spleen were determined in both groups at the time of sacrifice. The daily activity during 2 weeks after the second BA injection was significantly higher in the treated group than in the control. There was no difference in BW between both groups through the experimental course. Two mice in the control died 2 and 7 days after the second injection, whereas no mice in the treated group died. Significantly decreased SW and SW/BW ratio were observed in the treated mice together with elevation of splenic follicular area. There were suppressed IFN-gamma and IL-10 mRNA levels in spleens from the treated mice. Our results suggest that BYE might have a protective effect on the marked reduction in activity following repeated BA injection via normalization of host immune responses.

  14. Fatigue in neuromuscular disorders: Focus on Guillain-Barré syndrome and Pompe disease

    NARCIS (Netherlands)

    J.M. de Vries (Juna); M.L.C. Hagemans (Marloes); J.B.J. Bussmann (Hans); A.T. van der Ploeg (Ans); P.A. van Doorn (Pieter)

    2010-01-01

    textabstractFatigue accounts for an important part of the burden experienced by patients with neuromuscular disorders. Substantial high prevalence rates of fatigue are reported in a wide range of neuromuscular disorders, such as Guillain-Barré syndrome and Pompe disease. Fatigue can be subdivided

  15. 75 FR 61761 - Renewal of Charter for the Chronic Fatigue Syndrome Advisory Committee

    Science.gov (United States)

    2010-10-06

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES Renewal of Charter for the Chronic Fatigue Syndrome Advisory Committee AGENCY: Department... Chronic Fatigue Syndrome Advisory Committee (CFSAC). FOR FURTHER INFORMATION CONTACT: Wanda K. Jones,...

  16. Relationship between Fatigue and Gait Abnormality in Joint Hypermobility Syndrome/Ehlers-Danlos Syndrome Hypermobility Type

    Science.gov (United States)

    Celletti, Claudia; Galli, Manuela; Cimolin, Veronica; Castori, Marco; Albertini, Giorgio; Camerota, Filippo

    2012-01-01

    Ehlers-Danlos syndrome (EDS) is a clinically and genetically heterogeneous group of inherited connective tissue disorders characterised by joint hypermobility, skin hyperextensibility and tissue fragility. It has recently been shown that muscle weakness occurs frequently in EDS, and that fatigue is a common and clinically important symptom. The…

  17. 从壮医经筋学论治慢性疲劳综合征%Treatment Determination of Chronic Fatigue Syndrome from Muscle Region Theory of Zhuang Medicine

    Institute of Scientific and Technical Information of China (English)

    韦英才; 梁子茂

    2013-01-01

    Chronic fatigue syndrome (CFS) is a common disease and frequently-occurring disease in modern society, and the preva-lence is increasing, which is now a serious impact on the people’s working and the quality of life. The article would discuss the etiol-ogy and pathogenesis of chronic fatigue syndrome from the point of view of muscle region theory of Zhuang medicine. It believes that the muscles and tendons strain, infection of exogenous pathogens, fibrous node formation, collateral compression are the funda-mental reasons of pathogenesis; it has a good effect on alleviating symptoms of chronic fatigue syndrome such as fatigue, memory losses, sleep disorders and pain by using the tendons therapy of Zhuang Medicine, it’s worthy of further researching and concluding.%  慢性疲劳综合征(CFS)为现代社会常见病、多发病,且患病率呈上升趋势,严重影响了人们的工作和生活质量。文章从壮医筋病学角度探讨慢性疲劳综合征的病因病机。认为肌筋劳损,复感外邪,筋结形成,横络盛加是其发病的根本;治疗上采用壮医经筋疗法对缓解慢性疲劳综合征患者的疲劳、记忆力减退、睡眠障碍、疼痛等症状具有良好的疗效,值得深入研究总结。

  18. Cytokine expression profiles of immune imbalance in post-mononucleosis chronic fatigue

    Directory of Open Access Journals (Sweden)

    Broderick Gordon

    2012-09-01

    Full Text Available Abstract Background As Chronic Fatigue Syndrome (CFS has been known to follow Epstein-Bar virus (EBV and other systemic infections; our objective was to describe differences in immune activation in post-infective CFS (PI-CFS patients and recovered controls. We studied 301 adolescents prospectively over 24 months following the diagnosis of monospot-positive infectious mononucleosis (IM. We found an incidence of CFS at 6, 12 and 24 months of 13%, 7% and 4% respectively. Methods Using chemiluminescent imaging we measured the concentrations of IL-1a, 1b, 2, 4, 5, 6, 8, 10, 12 (p70, 13, 15, 17 and 23, IFN-γ, TNF-α and TNF-β in duplicate plasma samples available in bio-bank from 9 PI-CFS subjects and 12 recovered controls at 24 months post-infection. Results Standard comparative analysis indicated significant differences in IL-8 and 23 across subject groups. In constructing a linear classification model IL-6, 8 and 23 were selected by two different statistical approaches as discriminating features, with IL-1a, IL-2 and IFN-γ also selected in one model or the other. This supported an assignment accuracy of better than 80% at a confidence level of 0.95 into PI-CFS versus recovered controls. Conclusion These results suggest that co-expression patterns in as few as 5 cytokines associated with Th17 function may hold promise as a tool for the diagnosis of post-infectious CFS.

  19. A new hypothesis of chronic fatigue syndrome: co-conditioning theory.

    Science.gov (United States)

    Tanaka, Masaaki; Watanabe, Yasuyoshi

    2010-08-01

    Chronic fatigue syndrome is an illness characterized by a profound, disabling, and unexplained sensation of fatigue lasting at least 6 months, which severely impairs daily functioning and is accompanied by a combination of non-specific symptoms. Many potential causes of chronic fatigue syndrome have been investigated, including viral infections, immune dysfunctions, abnormal neuroendocrine responses, central nervous system abnormalities, autonomic dysfunctions, impaired exercise capacities, sleep disruptions, genetic backgrounds, psychiatric abnormalities, personality, and abnormal psychological processes. However, no etiology, specific physical signs or laboratory test abnormalities have been found. It is essential to establish a conceptual theory of chronic fatigue syndrome that can explain its pathophysiology in order to identify the clinical entity and to develop effective treatment methods. In this article, a new conceptual hypothesis about the pathophysiology of chronic fatigue syndrome, the co-conditioning theory, is presented: after repetitive overwork and/or stress, alarm signal to rest and fatigue sensation may cause in response to an unconditioned stimulus (impaired homeostasis and function) that has been paired with a conditioned stimulus (overwork and/or stress). In the future, a new treatment strategy for patients with chronic fatigue syndrome, re-co-conditioning therapy, may be developed on the basis of the co-conditioning theory. In addition, this theory will likely contribute to a better understanding of the pathophysiology of chronic fatigue syndrome. Copyright 2010 Elsevier Ltd. All rights reserved.

  20. Brief report: Writing about chronic fatigue increases somatic complaints

    Directory of Open Access Journals (Sweden)

    Mincke Frederix

    2013-12-01

    Full Text Available Participants were instructed to imagine that either they or a friend were suffering from chronic fatigue syndrome (CFS and were asked to fabricate a story about how CFS affected their own or their friend's daily functioning. Control participants were not given an imagination exercise but were asked to write about their study choice. After the writing exercise, all participants completed the Symptom Checklist-90 (SCL-90. Participants who had written a story about how CFS symptoms affected daily life (either their own life or that of a friend had higher scores on the Somatization subscale of the SCL-90 than controls. This finding resembles the misinformation effect documented by memory research, and suggests that elaborative writing about illness, through its symptom-escalating power, has iatrogenic potential.

  1. [Chronic fatigue syndrome. Clinical, social psychological problems and management].

    Science.gov (United States)

    Wessely, S

    1994-11-01

    Fatigue chronic syndrome (SFC) is the heir-at-law of neurasthenia. Both are seen like physical diseases and share certain therapeutic measures, such as sleep; they have the same symbolic function and enable patients as well as doctors reluctant to psychological dimensions of pathology, to get and express sympathy and attention. A strong controversy developed these last years concerning the SFC physiopathology particularly concerning the responsibility of viral infectious agents or psychiatric troubles. The SFC fatigue is unlikely hysterical or neuromuscular but it probably depends on several associated factors; cerebral neurobiochemistry anomalies (possibly induced by an infection or immune reactions), effort perception trouble, affective trouble, lack of physical activity. The handicap seems to be worse on account of unsuitable care and inefficacious treatment. Especially sleep, which is often beneficial in a short term, is source of ulterior chronicisation. Antidepressants are the only justified pharmacological treatment for SFC at the moment. Referring to the existence and the nature of cognitive distortions, the author suggests a cognitivo-behavioural therapy, whose aim is a progressive activity resumption.

  2. Fatigue in adults with Marfan syndrome, occurrence and associations to pain and other factors.

    Science.gov (United States)

    Bathen, Trine; Velvin, Gry; Rand-Hendriksen, Svend; Robinson, Hilde Stendal

    2014-08-01

    This study aims to investigate how fatigue affects adults with verified Marfan syndrome (MFS) in their daily lives, by examining fatigue levels and prevalence of severe fatigue compared to the general Norwegian population and individuals with other comparable chronic conditions. We investigated associations between socio-demographic characteristics, Marfan-related health problems, pain and fatigue. A cross-sectional study was conducted, using a postal questionnaire including the Fatigue Severity Scale (FSS) and questions on socio-demographic characteristics, Marfan-related health problems and pain. One hundred seventeen persons with MFS were invited to participate, 73 answered (62%). Participants reported significantly higher FSS scores and prevalence of severe fatigue compared to the general Norwegian population and patients with rheumatoid arthritis (RA), but lower than for other chronic conditions. Participants with chronic pain reported higher fatigue scores than those without chronic pain. Participants on disability benefits reported higher fatigue scores than participants who were working or enrolled in higher education. Marfan-related health problems like aortic dissection and use of blood pressure medication were not significantly associated with fatigue. In multivariable regression analyses chronic pain and employment status were significantly associated with fatigue. The final multivariable model explained 24% of the variance in fatigue scores. Our results show that fatigue is common in MFS patients and that it interferes with their daily lives. Chronic pain and employment status show significant associations to fatigue. This implies that fatigue is important to address when meeting MFS patients in clinical practice. There is need for more research on fatigue in Marfan syndrome.

  3. Postulated Vasoactive Neuropeptide Autoimmunity in Fatigue-Related Conditions: A Brief Review and Hypothesis

    Directory of Open Access Journals (Sweden)

    Donald R. Staines

    2006-01-01

    Full Text Available Disorders such as chronic fatigue syndrome (CFS and gulf war syndrome (GWS are characterised by prolonged fatigue and a range of debilitating symptoms of pain, intellectual and emotional impairment, chemical sensitivities and immunological dysfunction. Sudden infant death syndrome (SIDS surprisingly may have certain features in common with these conditions. Post-infection sequelae may be possible contributing factors although ongoing infection is unproven. Immunological aberration may prove to be associated with certain vasoactive neuropeptides (VN in the context of molecular mimicry, inappropriate immunological memory and autoimmunity.

  4. The process of change in pain during cognitive-behavior therapy for chronic fatigue syndrome.

    NARCIS (Netherlands)

    Bloot, L.; Heins, M.J.; Donders, R.; Bleijenberg, G.; Knoop, H.

    2015-01-01

    Background: Cognitive-behavior therapy (CBT) leads to a reduction of fatigue and pain in chronic fatigue syndrome. The processes underlying the reduction in pain have not been investigated. Recently, it was shown that increased self-efficacy, decreased focusing on symptoms, increased physical

  5. The Process of Change in Pain During Cognitive-Behavior Therapy for Chronic Fatigue Syndrome

    NARCIS (Netherlands)

    Bloot, L.; Heins, M.J.; Donders, R.; Bleijenberg, G.; Knoop, H.

    2015-01-01

    BACKGROUND: Cognitive-behavior therapy (CBT) leads to a reduction of fatigue and pain in chronic fatigue syndrome. The processes underlying the reduction in pain have not been investigated. Recently, it was shown that increased self-efficacy, decreased focusing on symptoms, increased physical

  6. Rheumatoid Arthritis Drug May Not Ease Chronic Fatigue Syndrome After All

    Science.gov (United States)

    ... page: https://medlineplus.gov/news/fullstory_163926.html Rheumatoid Arthritis Drug May Not Ease Chronic Fatigue Syndrome After ... had hoped that anakinra (Kineret) -- a medication for rheumatoid arthritis -- also could be used to relieve symptoms of ...

  7. Fatigue is a frequent and clinically relevant problem in Ehlers-Danlos Syndrome.

    NARCIS (Netherlands)

    Voermans, N.C.; Knoop, H.; Kamp, N. van de; Hamel, B.C.J.; Bleijenberg, G.; Engelen, B.G.M. van

    2010-01-01

    OBJECTIVES: Ehlers-Danlos Syndrome (EDS) is a clinically and genetically heterogeneous group of inherited connective tissue disorders characterized by joint hypermobility, skin hyperextensibility, and tissue fragility. Fatigue and musculoskeletal pain are associated features but have never been stud

  8. Patients with chronic fatigue syndrome performed worse than controls in a controlled repeated exercise study despite a normal oxidative phosphorylation capacity

    Directory of Open Access Journals (Sweden)

    Sluiter Wim

    2010-10-01

    Full Text Available Abstract Background The aim of this study was to investigate the possibility that a decreased mitochondrial ATP synthesis causes muscular and mental fatigue and plays a role in the pathophysiology of the chronic fatigue syndrome (CFS/ME. Methods Female patients (n = 15 and controls (n = 15 performed a cardiopulmonary exercise test (CPET by cycling at a continuously increased work rate till maximal exertion. The CPET was repeated 24 h later. Before the tests, blood was taken for the isolation of peripheral blood mononuclear cells (PBMC, which were processed in a special way to preserve their oxidative phosphorylation, which was tested later in the presence of ADP and phosphate in permeabilized cells with glutamate, malate and malonate plus or minus the complex I inhibitor rotenone, and succinate with rotenone plus or minus the complex II inhibitor malonate in order to measure the ATP production via Complex I and II, respectively. Plasma CK was determined as a surrogate measure of a decreased oxidative phosphorylation in muscle, since the previous finding that in a group of patients with external ophthalmoplegia the oxygen consumption by isolated muscle mitochondria correlated negatively with plasma creatine kinase, 24 h after exercise. Results At both exercise tests the patients reached the anaerobic threshold and the maximal exercise at a much lower oxygen consumption than the controls and this worsened in the second test. This implies an increase of lactate, the product of anaerobic glycolysis, and a decrease of the mitochondrial ATP production in the patients. In the past this was also found in patients with defects in the mitochondrial oxidative phosphorylation. However the oxidative phosphorylation in PBMC was similar in CFS/ME patients and controls. The plasma creatine kinase levels before and 24 h after exercise were low in patients and controls, suggesting normality of the muscular mitochondrial oxidative phosphorylation. Conclusion The

  9. Neuroendocrine perturbations in fibromyalgia and chronic fatigue syndrome.

    Science.gov (United States)

    Neeck, G; Crofford, L J

    2000-11-01

    A large body of data from a number of different laboratories worldwide has demonstrated a general tendency for reduced adrenocortical responsiveness in CFS. It is still not clear if this is secondary to CNS abnormalities leading to decreased activity of CRH- or AVP-producing hypothalamic neurons. Primary hypofunction of the CRH neurons has been described on the basis of genetic and environmental influences. Other pathways could secondarily influence HPA axis activity, however. For example, serotonergic and noradrenergic input acts to stimulate HPA axis activity. Deficient serotonergic activity in CFS has been suggested by some of the studies as reviewed here. In addition, hypofunction of sympathetic nervous system function has been described and could contribute to abnormalities of central components of the HPA axis. One could interpret the clinical trial of glucocorticoid replacement in patients with CFS as confirmation of adrenal insufficiency if one were convinced of a positive therapeutic effect. If patient symptoms were related to impaired activation of central components of the axis, replacing glucocorticoids would merely exacerbate symptoms caused by enhanced negative feedback. Further study of specific components of the HPA axis should ultimately clarify the reproducible abnormalities associated with a clinical picture of CFS. In contrast to CFS, the results of the different hormonal axes in FMS support the assumption that the distortion of the hormonal pattern observed can be attributed to hyperactivity of CRH neurons. This hyperactivity may be driven and sustained by stress exerted by chronic pain originating in the musculoskeletal system or by an alteration of the CNS mechanism of nociception. The elevated activity of CRH neurons also seems to cause alteration of the set point of other hormonal axes. In addition to its control of the adrenal hormones, CRH stimulates somatostatin secretion at the hypothalamic level, which, in turn, causes inhibition of

  10. Chronic fatigue syndrome in the media: a content analysis of newspaper articles.

    Science.gov (United States)

    Knudsen, Ann Kristen; Omenås, Anne Nagelgaard; Harvey, Samuel B; Løvvik, Camilla Ms; Lervik, Linn V; Mykletun, Arnstein

    2011-05-01

    Although cognitive behavioural therapy and graded exercise treatment are recognized evidence-based treatments for chronic fatigue syndrome/myalgic encephalomyelitis (ME), their use is still considered controversial by some patient groups. This debate has been reflected in the media, where many patients gather health information. The aim of this study was to examine how treatment for chronic fatigue syndrome/ME is described in the newspaper media. Content analysis of newspaper articles. The digitalized media archive Atekst was used to identify Norwegian newspaper articles where chronic fatigue syndrome/ME was mentioned. Norwegian newspaper articles published over a 20-month period, from 1 January 2008 to 31 August 2009. Statements regarding efficiency of various types of treatment for chronic fatigue syndrome/ME and the related source of the treatment advice. Statements were categorized as being either positive or negative towards evidence-based or alternative treatment. One hundred and twenty-two statements regarding treatment of chronic fatigue syndrome/ME were identified among 123 newspaper articles. The most frequent statements were positive statements towards alternative treatment Lightning Process (26.2%), negative statements towards evidence-based treatments (22.1%), and positive statements towards other alternative treatment interventions (22.1%). Only 14.8% of the statements were positive towards evidence-based treatment. Case-subjects were the most frequently cited sources, accounting for 35.2% of the statements, followed by physicians and the Norwegian ME association. Statements regarding treatment for chronic fatigue syndrome/ME in newspapers are mainly pro-alternative treatment and against evidence-based treatment. The media has great potential to influence individual choices. The unbalanced reporting of treatment options for chronic fatigue syndrome/ME in the media is potentially harmful.

  11. Association between Fatigue and Autistic Symptoms in Children with Cri du Chat Syndrome

    Science.gov (United States)

    Claro, Anthony; Cornish, Kim; Gruber, Reut

    2011-01-01

    In the current study, the authors examined whether the fatigue level of children diagnosed with cri du chat syndrome was associated with the expression of autistic symptoms. Sixty-nine children with cri du chat syndrome were compared with 47 children with moderate to severe intellectual disabilities who did not differ on intellectual severity.…

  12. 心理保健操对某高原汽车部队军人慢性疲劳综合征的康复作用%Rehabilitation Effect of Psychological Conditioning Exercise in Treatment of Truck Drivers with Chronic Fatigue Syndrome in One PLA Unit in the Plateau

    Institute of Scientific and Technical Information of China (English)

    樊璐璐; 卢宁; 白艳; 黄建国; 陈效

    2016-01-01

    Objective To investigate effect of psychological conditioning exercise in rehabilitation of truck driv-ers of PLA troops with chronic fatigue syndrome ( CFS) in the plateau. Methods A total of 335 truck soldiers were ran-domly selected from one troops in Sinkiang plateau. All truck drivers were detected with CFS self-evaluation table, and 90 truck drivers were confirmed as having CFS after suspicious CFS truck drivers were followed up by psychological practi-tioner one by one. The 90 soldiers were divided into observation and control groups. Observation group was treated with psychological conditioning exercise. Fatigue scores were detected before and after intervention for 1 week and 2 weeks u-sing Fatigue Scale-14 (FS-14). Results In observation group, fatigue degrees of soldiers at different time points were different, and it showed a descending trend, and the differences were statistically significant (P<0. 05). After interven-tion for 2 weeks, the descending degrees in physical, mental and total fatigue rates were 47. 3%, 27. 7% and 39. 8% re-spectively, and improvement in physical fatigue degree was the most obvious (P<0. 05). Conclusion Psychological conditioning exercise can alleviate fatigue score of CFS patients to some extent, and therefore it plays an important role in treatment of PLA truck drivers with CFS in the plateau.%目的:探讨心理保健操对高原汽车部队军人慢性疲劳综合征的康复作用。方法随机抽取驻疆某部高原汽车部队军人335名,通过慢性疲劳综合征( CFS)自评量表进行调查,由心理医师对疑似CFS者逐一回访,明确诊断CFS患者90名,随机分为2组,观察组给予心理保健操干预治疗,对照组为空白对照,用疲劳量表-14评定干预前、干预后1周及2周的疲劳评分。结果观察组在不同时间点的疲劳程度不同,且呈降低趋势,差异有统计学意义(P<0.05)。干预2周后体力、脑力及疲劳总分下降程度分别为47

  13. Effect of whey protein on the rehabilitation of plateau truck soldiers with chronic fatigue syndrome%乳清蛋白治疗高原汽车驾驶人员慢性疲劳综合征的疗效观察

    Institute of Scientific and Technical Information of China (English)

    卢宁; 徐辉; 白艳; 黄建国; 韦红梅; 赵晓伟; 王勇强

    2014-01-01

    目的:探讨乳清蛋白对患有慢性疲劳综合征( chronic fatigue syndrome,CFS)的高原汽车驾驶人员的康复作用。方法选取新疆军区某部高原汽车驾驶人员268名,根据美国疾病控制中心1994修订的CFS诊断标准,通过CFS自评表进行调查,再由心理科医师对可疑CFS患者进行回访以明确诊断,筛选出CFS患者62名,将其中50名高原汽车驾驶人员分为5组,每组10名。除空白对照组外,4组患者分别接受不同的抗疲劳治疗:补充乳清蛋白、补充铁剂、心理干预及综合治疗(同时补充乳清蛋白、铁剂及心理干预)。用疲劳量表14(the Fatigue Scale-14,FS-14)评定干预前、干预后1周及2周分值。结果CFS患病率为23.1%(62/268)。对照组、接受乳清蛋白治疗和综合治疗的患者在不同时间点的疲劳程度不同,差异有统计学意义。对照组疲劳评分呈增加趋势,乳清蛋白治疗和综合治疗组疲劳评分呈降低趋势,体力疲劳和脑力疲劳评分分别下降44.6%~47.6%和60.5%。而心理治疗、铁剂治疗前后疲劳评分改变差异无统计学意义。结论高原汽车驾驶人员患CFS值得关注,口服乳清蛋白可在一定程度上减轻CFS。%Objective To explore the efficacy of whey protein on the rehabilitation of chronic fatigue syndrome (CFS) in truck soldiers on the plateau.Methods Two hundred and sixty-eight of plateau truck soldiers were selected from Xinjiang Military Command,according to the centers for disease control symptoms of diagnostic criteria specified in the revision of the CFS of 1994.Sixty-two CFS patients were screened by investigation of the CFS self-evaluation table and diagnosed by psychological practitioner for suspi-cious CFS again one by one.Of which,50 plateau truck troops were divided into 5 groups,each group contained 10 soldiers,one group used as blank control,the rest of the four groups of CFS soldiers

  14. Fatigue in primary Sjögren's syndrome is associated with lower levels of proinflammatory cytokines

    Science.gov (United States)

    Howard Tripp, Nadia; Tarn, Jessica; Natasari, Andini; Gillespie, Colin; Mitchell, Sheryl; Hackett, Katie L; Bowman, Simon J; Price, Elizabeth; Pease, Colin T; Emery, Paul; Lanyon, Peter; Hunter, John; Gupta, Monica; Bombardieri, Michele; Sutcliffe, Nurhan; Pitzalis, Costantino; McLaren, John; Cooper, Annie; Regan, Marian; Giles, Ian; Isenberg, David A; Saravanan, Vadivelu; Coady, David; Dasgupta, Bhaskar; McHugh, Neil; Young-Min, Steven; Moots, Robert; Gendi, Nagui; Akil, Mohammed; Griffiths, Bridget; Lendrem, Dennis W; Ng, Wan-Fai

    2016-01-01

    Objectives This article reports relationships between serum cytokine levels and patient-reported levels of fatigue, in the chronic immunological condition primary Sjögren's syndrome (pSS). Methods Blood levels of 24 cytokines were measured in 159 patients with pSS from the United Kingdom Primary Sjögren's Syndrome Registry and 28 healthy non-fatigued controls. Differences between cytokines in cases and controls were evaluated using Wilcoxon test. Patient-reported scores for fatigue were evaluated, classified according to severity and compared with cytokine levels using analysis of variance. Logistic regression was used to determine the most important predictors of fatigue levels. Results 14 cytokines were significantly higher in patients with pSS (n=159) compared to non-fatigued healthy controls (n=28). While serum levels were elevated in patients with pSS compared to healthy controls, unexpectedly, the levels of 4 proinflammatory cytokines—interferon-γ-induced protein-10 (IP-10) (p=0.019), tumour necrosis factor-α (p=0.046), lymphotoxin-α (p=0.034) and interferon-γ (IFN-γ) (p=0.022)—were inversely related to patient-reported levels of fatigue. A regression model predicting fatigue levels in pSS based on cytokine levels, disease-specific and clinical parameters, as well as anxiety, pain and depression, revealed IP-10, IFN-γ (both inversely), pain and depression (both positively) as the most important predictors of fatigue. This model correctly predicts fatigue levels with reasonable (67%) accuracy. Conclusions Cytokines, pain and depression appear to be the most powerful predictors of fatigue in pSS. Our data challenge the notion that proinflammatory cytokines directly mediate fatigue in chronic immunological conditions. Instead, we hypothesise that mechanisms regulating inflammatory responses may be important. PMID:27493792

  15. Physical activity and physical activity cognitions are potential factors maintaining fatigue in patients with primary Sjogren's syndrome

    NARCIS (Netherlands)

    Wouters, Eveline J. M.; van Leeuwen, Ninke; Bossema, Ercolie R.; Kruize, Aike A.; Bootsma, Hendrika; Bijlsma, Johannes W. J.; Geenen, Rinie

    Background Fatigue is a prevalent and debilitating problem in Sjogren's syndrome. It has been suggested that physical activity and cognitions about physical activity can influence fatigue. Objective The aim of this study was to examine fatigue and physical activity levels in patients with Sjogren's

  16. Physical activity and physical activity cognitions are potential factors maintaining fatigue in patients with primary Sjögren's syndrome

    NARCIS (Netherlands)

    Van Leeuwen; MD E.J.M. Wouters; Bossema; Bootsma; Geenen; Kruize; Bijlsma

    2012-01-01

    Background Fatigue is a prevalent and debilitating problem in Sjögren's syndrome. It has been suggested that physical activity and cognitions about physical activity can influence fatigue. Objective The aim of this study was to examine fatigue and physical activity levels in patients with Sjögren's

  17. Physical activity and physical activity cognitions are potential factors maintaining fatigue in patients with primary Sjogren's syndrome

    NARCIS (Netherlands)

    Wouters, Eveline J. M.; van Leeuwen, Ninke; Bossema, Ercolie R.; Kruize, Aike A.; Bootsma, Hendrika; Bijlsma, Johannes W. J.; Geenen, Rinie

    2012-01-01

    Background Fatigue is a prevalent and debilitating problem in Sjogren's syndrome. It has been suggested that physical activity and cognitions about physical activity can influence fatigue. Objective The aim of this study was to examine fatigue and physical activity levels in patients with Sjogren's

  18. Correlation between chronic fatigue syndrome and occupational stress in nurses of intensive care unit%重症监护室护士慢性疲劳综合征与职业紧张的相关性

    Institute of Scientific and Technical Information of China (English)

    魏小妹; 李大登

    2015-01-01

    目的 调查重症监护室护士职业紧张现状与慢性疲劳综合征(CFS)发生率,并探讨其相关性.方法 选取2013年7月-2014年7月在荆州市10所综合性医院任职共235名ICU护士为研究对象,采用自制一般情况调查表、职业紧张量表(OSIR)和疲劳量表-14(FS-14)对其进行调查.结果 ICU护士职业紧张度最高发生在30~39岁年龄段,护龄在10~19 a、学历中专、常白夜班倒班、在编护士以及离婚和丧偶护士群体中,CFS的发生与年龄无关(P>0.05);疲劳总分、躯体疲劳、脑力疲劳得分分别与职业任务、个体紧张反应得分呈正相关,与个体应变能力得分呈负相关,差异有统计学意义(P<0.05).结论 ICU护士职业紧张情况较为严重,可通过缓解其职业紧张水平,从而降低患CFS的风险.%[Objective] To investigate the current situation of chronic fatigue syndrome and incidence rate of chronic fatigue syndrome (CFS) in nurses of intensive care unit (ICU),explore their correlation.[Methods] 235 ICU nurses were collected from 10 general hospitals in Jingzhou City from July 2013 to July 2014,and were investigated by the self-made general questionnaire,the Occupational stress inventory-revised (OSIR) and the Fatigue scale-14 (FS-14).[Results] The incidence rate of occupational stress was the highest in the ICU nurses aged 20-39 years old,with the working age of 10-19 years,education level of technical secondary school,on day-night shifts,authorized nurses,and divorced/widowed nurses.CFS was not related to age (P>0.05).The total fatigue scores,physical fatigue scores,mental fatigue scores were positively correlated with occupational tasks and individual stress response scores,while that were negatively correlated with the individual adaptability scores,and the differences were statistically significant (P<0.05).[Conclusion] The occupational stress situation is more serious in ICU nurses.It is feasible to alleviate the level of

  19. Immunogenetic background of patients with autoimmune fatigue syndrome.

    Science.gov (United States)

    Itoh, Y; Igarashi, T; Tatsuma, N; Imai, T; Yoshida, J; Tsuchiya, M; Murakami, M; Fukunaga, Y

    2000-10-01

    We have previously reported that approximately 50% of children with chronic nonspecific complaints were positive for antinuclear antibodies (ANA), and that a novel autoantibody to a 62 kD protein (anti-Sa) was found in 40% of these ANA-positive patients. Therefore, we proposed a distinct disease entity termed autoimmune fatigue syndrome (AIFS). We hypothesized that if autoimmune mechanisms did play an important role in the pathogenesis of AIFS, it is possible that it is immunogenetically regulated as observed in other autoimmune disorders. In order to examine the immunogenetic background of AIFS patients, HLA-A, -B, -C, and -DR loci were analyzed serologically in 61 AIFS patients. AIFS was found to be positively associated with the class I antigen HLA-B61 and with the class II antigen HLA-DR9, with odds ratios of 2.77 (p = 0.015, Pcorr = 0.48) and 2.60 (p= 0.012, Pcorr = 0.17), respectively. A negative association was also found between AIFS and HLA-DR2 with odds ratio of 0.25 (p = 0.029, Pcorr = 0.041). When comparing anti-Sa positive AIFS patients with healthy controls, the odds ratios associated with HLA-B61, DR9, and DR2 were 3.42 (p = 0.021, Pcorr = 0.22), 3.96 (p = 0.0011, Pcorr = 0.015), and 0.16 (p = 0.0022, Porr = 0.031), respectively. Thus, the HLA associations observed in this study suggested that immunogenetic background might play a role in AIFS.

  20. Impact of IL-1 inhibition on fatigue associated with autoinflammatory syndromes.

    Science.gov (United States)

    Yadlapati, Sujani; Efthimiou, Petros

    2016-01-01

    Cryopyrin-associated periodic syndromes (CAPS) is a rare group of autoinflammatory disorders that includes familial cold autoinflammatory syndrome or FCAS, Muckle-wells syndrome or MWS, and neonatal-onset multisystem inflammatory disease or NOMID. CAPS is caused by a mutation in the NOD-like receptor family, pyrin domain containing 3 (NLRP3) gene. This ultimately leads to increased production of interleukin (IL)-1β. IL-1β is a biologically active member of the IL-1 family. It is not only a pro-inflammatory cytokine responsible for features such as fever, rash, and arthritis, but is also a major mediator in the central pathways of fatigue. Fatigue is a major component of CAPS and is associated with severely compromised quality of life. In clinical studies, fatigue was measured using functional assessment of chronic illness therapy-fatigue or FACIT-F and short form-36 or SF-36, physical component score instruments. These questionnaires can also be used to monitor improvement of fatigue following initiation of therapy. IL-1 inhibitors block the IL-1 signaling cascade, thereby preventing systemic inflammation in CAPS. The decrease in systemic inflammation is accompanied by improvement in fatigue.

  1. Early predicting value of chronic fatigue syndrome with organism weak magnetic field analytic technology for male health examination group%生物体微弱磁场测定技术对男性体检人群中慢性疲劳综合征的早期预警价值

    Institute of Scientific and Technical Information of China (English)

    赵峰; 张群; 英明中

    2012-01-01

    Objective To explore the early warning significance of organism weak magnetic field analytic technology to the normal male physical examination group for chronic fatigue syndrome ( CFS ). Methods Totally 2323 men were selected as samples, who had accepted health examination in the International Medical Center, the PLA General Hospital, from August 2010 to July 2011. The people had excluded with other diseases. According to the U. S. CDC diagnostic criteria of the CFS, 373 cases were diagnosed CFS, other 373 normal subjects were enrolled as control group, all cases were tested the urine samples for the weak magnetic field information and analyzed the correlation of relevant information with CFS. Results Through the sample survey questionnaire, it was found that the men have higher incidence of CFS ( 16. 1% , 373/2323 ). Weak magnetic field analytic results compared with the chronic fatigue related indicators, such as sleep related indicators, psychological related indicators in the CFS populations were significantly higher than that in the normal population( P < 0.05, P <0. 01 ). Weak magnetic field analytic technology could serve as early warning indicators of CFS. Conclusion Organisms weak magnetic field analytic technology could serve as the early warning indicators of CFS for healthy people.%目的 探讨生物体微弱磁场测定技术对正常男性体检人群慢性疲劳综合征(CFS)早期预警的意义.方法 入选样本选自2010年8月至2011年7月解放军总医院国际医学中心健康体检、排除已诊断其他疾病者2323例,均为男性,按照美国疾病控制中心(CDC)标准诊断诊断为CFS 373例,另抽取373例体检正常者作对照(正常组),检测尿液中微弱磁场信息,并进行对比分析.结果 利用调查问卷发现CFS发生率为16.1%(373/2323).应用微弱磁场测定结果对比,发现与睡眠相关指标(δ波、脑-内分泌、脑-营养、松果体、百会、脑能量等)、心理情绪相关因素指标(α

  2. Evaluation of Kinesiophobia and Its Correlations with Pain and Fatigue in Joint Hypermobility Syndrome/Ehlers-Danlos Syndrome Hypermobility Type

    Directory of Open Access Journals (Sweden)

    Claudia Celletti

    2013-01-01

    Full Text Available Ehlers-Danlos syndrome hypermobility type a. k. a. joint hypermobility syndrome (JHS/EDS-HT is a hereditary musculoskeletal disorder associating generalized joint hypermobility with chronic pain. Anecdotal reports suggest a prominent role for kinesiophobia in disease manifestations, but no study has systematically addressed this point. Objective. To investigate the impact of kinesiophobia and its relationship with pain, fatigue, and quality of life in JHS/EDS-HT. Design. Cross-sectional study. Subjects/Patients. 42 patients (40 female and 2 male with JHS/EDS-HT diagnosis following standardized diagnostic criteria were selected. Methods. Disease features were analyzed by means of specific questionnaires and scales evaluating kinesiophobia, pain, fatigue, and quality of life. The relationships among variables were investigated using the Spearman bivariate analysis. Results. Kinesiophobia resulted predominantly in the patients’ sample. The values of kinesiophobia did not correlate with intensity of pain, quality of life, and (or the single component of fatigue. A strong correlation was discovered between kinesiophobia and general severity of fatigue. Conclusions. In JHS/EDS-HT, the onset of pain-avoiding strategies is related to the presence of pain but not to its intensity. The clear-cut correlation between kinesiophobia and severity of fatigue suggests a direct link between musculoskeletal pain and fatigue. In JHS/EDS-HT, the underlying mechanism is likely to be facilitated by primary disease characteristics, including hypotonia.

  3. Interstitial Cystitis/Painful Bladder Syndrome and Associated Medical Conditions With an Emphasis on Irritable Bowel Syndrome, Fibromyalgia and Chronic Fatigue Syndrome

    DEFF Research Database (Denmark)

    Nickel, J.C.; Tripp, D.A.; Pontari, M.

    2010-01-01

    Purpose: We characterized and compared the impact of clinical phenotypic associations between interstitial cystitis/painful bladder syndrome and controls in relation to potentially related conditions, particularly irritable bowel syndrome, fibromyalgia and chronic fatigue syndrome. Materials...... validated questionnaires focused on symptoms, suffering/coping and behavioral/social factors. Results: Questionnaires were completed by 205 patients with interstitial cystitis/painful bladder syndrome and 117 controls matched for age. Prevalence of selfreported associated condition diagnosis in interstitial...... cystitis/painful bladder syndrome vs controls was irritable bowel syndrome 38.6% vs 5.2%, fibromyalgia 17.7% vs 2.6% and chronic fatigue syndrome 9.5% vs 1.7% (all p

  4. A Transcriptional Signature of Fatigue Derived from Patients with Primary Sjögren’s Syndrome

    Science.gov (United States)

    James, Katherine; Al-Ali, Shereen; Tarn, Jessica; Cockell, Simon J.; Gillespie, Colin S.; Hindmarsh, Victoria; Locke, James; Mitchell, Sheryl; Lendrem, Dennis; Bowman, Simon; Price, Elizabeth; Pease, Colin T.; Emery, Paul; Lanyon, Peter; Hunter, John A.; Gupta, Monica; Bombardieri, Michele; Sutcliffe, Nurhan; Pitzalis, Costantino; McLaren, John; Cooper, Annie; Regan, Marian; Giles, Ian; Isenberg, David; Saravanan, Vadivelu; Coady, David; Dasgupta, Bhaskar; McHugh, Neil; Young-Min, Steven; Moots, Robert; Gendi, Nagui; Akil, Mohammed; Griffiths, Bridget; Wipat, Anil; Newton, Julia; Jones, David E.; Isaacs, John; Hallinan, Jennifer; Ng, Wan-Fai

    2015-01-01

    Background Fatigue is a debilitating condition with a significant impact on patients’ quality of life. Fatigue is frequently reported by patients suffering from primary Sjögren’s Syndrome (pSS), a chronic autoimmune condition characterised by dryness of the eyes and the mouth. However, although fatigue is common in pSS, it does not manifest in all sufferers, providing an excellent model with which to explore the potential underpinning biological mechanisms. Methods Whole blood samples from 133 fully-phenotyped pSS patients stratified for the presence of fatigue, collected by the UK primary Sjögren’s Syndrome Registry, were used for whole genome microarray. The resulting data were analysed both on a gene by gene basis and using pre-defined groups of genes. Finally, gene set enrichment analysis (GSEA) was used as a feature selection technique for input into a support vector machine (SVM) classifier. Classification was assessed using area under curve (AUC) of receiver operator characteristic and standard error of Wilcoxon statistic, SE(W). Results Although no genes were individually found to be associated with fatigue, 19 metabolic pathways were enriched in the high fatigue patient group using GSEA. Analysis revealed that these enrichments arose from the presence of a subset of 55 genes. A radial kernel SVM classifier with this subset of genes as input displayed significantly improved performance over classifiers using all pathway genes as input. The classifiers had AUCs of 0.866 (SE(W) 0.002) and 0.525 (SE(W) 0.006), respectively. Conclusions Systematic analysis of gene expression data from pSS patients discordant for fatigue identified 55 genes which are predictive of fatigue level using SVM classification. This list represents the first step in understanding the underlying pathophysiological mechanisms of fatigue in patients with pSS. PMID:26694930

  5. A Transcriptional Signature of Fatigue Derived from Patients with Primary Sjogren's Syndrome.

    Directory of Open Access Journals (Sweden)

    Katherine James

    Full Text Available Fatigue is a debilitating condition with a significant impact on patients' quality of life. Fatigue is frequently reported by patients suffering from primary Sjögren's Syndrome (pSS, a chronic autoimmune condition characterised by dryness of the eyes and the mouth. However, although fatigue is common in pSS, it does not manifest in all sufferers, providing an excellent model with which to explore the potential underpinning biological mechanisms.Whole blood samples from 133 fully-phenotyped pSS patients stratified for the presence of fatigue, collected by the UK primary Sjögren's Syndrome Registry, were used for whole genome microarray. The resulting data were analysed both on a gene by gene basis and using pre-defined groups of genes. Finally, gene set enrichment analysis (GSEA was used as a feature selection technique for input into a support vector machine (SVM classifier. Classification was assessed using area under curve (AUC of receiver operator characteristic and standard error of Wilcoxon statistic, SE(W.Although no genes were individually found to be associated with fatigue, 19 metabolic pathways were enriched in the high fatigue patient group using GSEA. Analysis revealed that these enrichments arose from the presence of a subset of 55 genes. A radial kernel SVM classifier with this subset of genes as input displayed significantly improved performance over classifiers using all pathway genes as input. The classifiers had AUCs of 0.866 (SE(W 0.002 and 0.525 (SE(W 0.006, respectively.Systematic analysis of gene expression data from pSS patients discordant for fatigue identified 55 genes which are predictive of fatigue level using SVM classification. This list represents the first step in understanding the underlying pathophysiological mechanisms of fatigue in patients with pSS.

  6. A Disease Register for ME/CFS: Report of a Pilot Study

    Directory of Open Access Journals (Sweden)

    Featherstone Valerie

    2011-05-01

    Full Text Available Abstract Background The ME/CFS Disease Register is one of six subprojects within the National ME/CFS Observatory, a research programme funded by the Big Lottery Fund and sponsored by Action for ME. A pilot study in East Anglia, East Yorkshire, and London aimed to address the problem of identifying representative groups of subjects for research, in order to be able to draw conclusions applicable to the whole ME/CFS population. While not aiming for comprehensive population coverage, this pilot register sought to recruit participants with ME/CFS in an unbiased way from a large population base. Those recruited are constituting a cohort for long-term follow-up to shed light on prognosis, and a sampling frame for other studies. Findings Patients with unidentified chronic fatigue were identified in GP databases using a READ-code based algorithm, and conformity to certain case definitions for ME/CFS determined. 29 practices, covering a population aged 18 to 64 of 143,153, participated. 510 patients with unexplained chronic fatigue were identified. 265 of these conformed to one or more case definitions. 216 were invited to join the register; 160 agreed. 96.9% of participants conformed to the CDC 1994 (Fukuda definition; the Canadian definition defined more precisely a subset of these. The addition of an epidemiological case definition increased case ascertainment by approximately 4%. A small-scale study in a specialist referral service in East Anglia was also undertaken. There was little difference in pattern of conformity to case definitions, age or sex among disease register participants compared with subjects in a parallel epidemiological study who declined to participate. One-year follow-up of 50 subjects showed little change in pain or fatigue scores. There were some changes in conformity to case definitions. Conclusions Objective evaluation indicated that the aim of recruiting participants with ME/CFS to a Disease Register had been fulfilled, and

  7. Family-focused cognitive behaviour therapy versus psycho-education for adolescents with chronic fatigue syndrome: long-term follow-up of an RCT.

    Science.gov (United States)

    Lloyd, Samantha; Chalder, Trudie; Rimes, Katharine A

    2012-11-01

    The aim of this study was to investigate the long term efficacy of family-focused cognitive behaviour therapy (CBT) compared with psycho-education in improving school attendance and other secondary outcomes in adolescents with chronic fatigue syndrome (CFS). A 24 month follow-up of a randomised controlled trial was carried out. Participants received either 13 one-hour sessions of family-focused CBT or four one-hour sessions of psycho-education. Forty-four participants took part in the follow-up study. The proportion of participants reporting at least 70% school attendance (the primary outcome) at 24 months was 90% in CBT group and 84% in psycho-education group; the difference between the groups was not statistically significant (OR = 1.29, p = 0.80). The proportion of adolescents who had recovered in the family-focused CBT group was 79% compared with 64% in the psycho-education, according to a definition including fatigue and school attendance. This difference was not statistically significant (Fisher's exact test, p = 0.34). Family-focused CBT was associated with significantly better emotional and behavioural adjustment at 24 month follow-up compared to psycho-education, as reported by both adolescents (F = 6.49, p = 0.02) and parents (F = 4.52, P = 0.04). Impairment significantly decreased in both groups between six and 24 month follow-ups, with no significant group difference in improvement over this period. Gains previously observed for other secondary outcomes at six month follow-up were maintained at 24 month follow-up with no further significant improvement or group differences in improvement. In conclusion, gains achieved by adolescents with CFS who had undertaken family-focused CBT and psycho-education generally continued or were maintained at two-year follow-up. The exception was that family-focused CBT was associated with maintained improvements in emotional and behavioural difficulties whereas psycho-education was associated with

  8. Chronic fatigue syndrome and fibromyalgia. Dilemmas in diagnosis and clinical management.

    Science.gov (United States)

    Demitrack, M A

    1998-09-01

    There has been a resurgence of interest in recent years in both chronic fatigue syndrome and fibromyalgia. These perplexing and common clinical conditions are a source of significant patient morbidity and frame one of the more enduring dilemmas of contemporary Western medical thought, namely the ambiguous interface between mind and body. In this article, the current definitions are reviewed, and a framework for an emerging psychobiological model of these syndromes is presented. These issues are synthesized into a pragmatic approach to clinical management.

  9. Phylogeny-Directed Search for Murine Leukemia Virus-Like Retroviruses in Vertebrate Genomes and in Patients Suffering from Myalgic Encephalomyelitis/Chronic Fatigue Syndrome and Prostate Cancer

    Directory of Open Access Journals (Sweden)

    Jonas Blomberg

    2011-01-01

    Full Text Available Gammaretrovirus-like sequences occur in most vertebrate genomes. Murine Leukemia Virus (MLV like retroviruses (MLLVs are a subset, which may be pathogenic and spread cross-species. Retroviruses highly similar to MLLVs (xenotropic murine retrovirus related virus (XMRV and Human Mouse retrovirus-like RetroViruses (HMRVs reported from patients suffering from prostate cancer (PC and myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS raise the possibility that also humans have been infected. Structurally intact, potentially infectious MLLVs occur in the genomes of some mammals, especially mouse. Mouse MLLVs contain three major groups. One, MERV G3, contained MLVs and XMRV/HMRV. Its presence in mouse DNA, and the abundance of xenotropic MLVs in biologicals, is a source of false positivity. Theoretically, XMRV/HMRV could be one of several MLLV transspecies infections. MLLV pathobiology and diversity indicate optimal strategies for investigating XMRV/HMRV in humans and raise ethical concerns. The alternatives that XMRV/HMRV may give a hard-to-detect “stealth” infection, or that XMRV/HMRV never reached humans, have to be considered.

  10. Analyzing the Core Flight Software (CFS) with SAVE

    Science.gov (United States)

    Ganesan, Dharmalingam; Lindvall, Mikael; McComas, David

    2008-01-01

    This viewgraph presentation describes the SAVE tool and it's application to Core Flight Software (CFS). The contents include: 1) Fraunhofer-a short intro; 2) Context of this Collaboration; 3) CFS-Core Flight Software?; 4) The SAVE Tool; 5) Applying SAVE to CFS -A few example analyses; and 6) Goals.

  11. The burden of Sjögren's syndrome, dryness and fatigue

    NARCIS (Netherlands)

    van Leeuwen, N.

    2014-01-01

    Dryness and fatigue are prevalent and debilitating symptoms in Sjögren’s syndrome. In this thesis, consequences of dryness for patients’ well-being and daily life functioning, and possible targets for treatment were described. In the first part of this thesis, an encompassing overview of the

  12. Efficacy Observation on Moxibustion on Guanyuan and Feishu for Pulmonary Tuberculosis Complicated with Chronic Fatigue Syndrome%艾灸关元、肺俞穴治疗肺结核合并慢性疲劳综合征疗效观察

    Institute of Scientific and Technical Information of China (English)

    吴文斌; 付喜花; 郭健

    2014-01-01

    目的:观察艾灸关元、肺俞穴治疗肺结核合并慢性疲劳综合征(chronic fatigue syndrome,CFS)的疗效。方法:将80例肺结核合并CFS患者随机分为治疗组(40例)和对照组(40例),两组患者均给予常规药物治疗,治疗组则在常规治疗基础上采用艾条温和灸关元、肺俞穴,4周为一个疗程,一个疗程后采用多维疲劳问卷(Multidimensional Fatigue Inventory,MFI-20)评定疗效。结果:治疗组总体疲劳、生理疲劳、精神疲劳、活动减少、兴趣减少等MFI-20评分均显著低于对照组(P<0.01)。结论:艾灸关元、肺俞穴治疗肺结核合并CFS疗效显著,值得临床推广应用。%Objective:To observe the efficacy of moxibustion on Guanyuan and Feishu for pulmonary tuberculosis complicated with chronic fatigue syndrome (CFS). Methods:80 cases of patients with pulmonary tuberculosis complicated with CFS were randomly divided into treatment group (40 cases) and control group (40 cases), both groups of patients were all treated by conventional medication, while treatment group also used moxibus-tion therapy on Guanyuan and Feishu acupoints on the basis of conventional medication, 4 weeks as a course of treatment, and evaluated efficacy by Multidimensional Fatigue Inventory (MFI-20) after a course of treatment. Results:The MFI-20 scores such as overall fatigue, physiological fatigue, mental fatigue, activity reduction, interest reduction of treatment group were all significantly lower than those of control group (P<0.01). Conclusion:Moxibustion on Guanyuan and Feishu has significant curative effect on pulmonary tuberculosis complicated with CFS, deserves clinical promotion and application.

  13. 参精煎方治疗慢性疲劳综合征62例%Clinical Observation of Shenjing Recipe in Treating 62 Patients with Chronic Fatigue Syndrome

    Institute of Scientific and Technical Information of China (English)

    李乐军; 肖辉; 陈隐漪; 马先军; 卞光荣; 王惠; 乔本玉

    2011-01-01

    Objective: To investigate the effects of Chinese medicine on chronic fatigue syndrome (CFS). Method:One hundred fifteen CFS patients meeting the inclusive criteria were enrolled from March 2008 to April 2010 and randomized into two groups. The 62 patents in the treated group were orally treated with Shenjing Recipe (200 mL of decoction) , for 100 mL twice daily. The 53 patients in the control group were treated with vitamin B tablets (10 mg twice daily) ,and Oregano tablets(20 mg thrice a day). Result: After treatment the difference in scores of fatigue symptoms between the two groups was significant ( P < 0. 01 ) , the scores of various SCL-90 factors and the total scores significantly reduced in the treated group after treatment (P < 0. 01). Conclusion: Shenjing recipe shows superiority in treating CFS.%目的:探讨对慢性疲劳综合征(chronic fatigue syndrome,CFS)有效的中医疗法.方法:选取符合纳入标准的CFS患者115例,分为两组;治疗组62例,采用中药参精煎方(由何首乌15 g,人参10 g,枸杞10g,黄芪10 g,女贞子10 g,菟丝子10g,五味子10 g,黄精10 g,淮山药10 g,益智仁15g,合欢皮10g,郁金10 g组成.本院煎药室统一煎煮,真空包装,每袋200 mL,每次1袋,分早晚2次服用).对照组53例,给予金施尔康1片,1次/d,谷维素20 mg,3次/d;连续服药3个月.观察两组神经心理学量表,包括多维疲劳问卷(multidimensional fatigue inventory,MFI-20)、治疗前后精神症状自评量表SCL-90评分、抑郁自评量表(self-rating depression scale,SDS)及焦虑自评量表(self-rating anxiety scale,SAS)等指标.结果:治疗后两组疲劳积分比较,差异有统计学意义(P<0.01);治疗组治疗后SCL-90各因子评分及总评分较治疗前降低(P<0.01);抑郁自评量表及焦虑自评量表比较,差异均无统计学意义,与治疗前比较,差异均有统计学意义(P<0.05);与对照组治疗后比较,差异亦有统计学意义(P<0.05).结论:中药参精煎方治疗CFS疗效明显.

  14. A case control study of premorbid and currently reported physical activity levels in chronic fatigue syndrome

    Directory of Open Access Journals (Sweden)

    Buchwald Dedra

    2006-11-01

    Full Text Available Abstract Background Patients with chronic fatigue syndrome typically report high levels of physical activity before becoming ill. Few studies have examined premorbid and current activity levels in chronically fatigued patients. Methods In a case-control study, 33 patients with chronic, unexplained, disabling fatigue attending a university-based clinic specializing in fatigue were compared to 33 healthy, age- and sex-matched controls. Patients rated their activity levels before their illness and currently, using scales designed for this purpose. Controls reported their level of activity of 2 years previously and currently. Chi-square analyses, Student's t tests, and Wilcoxon signed rank tests were used in pair matched analyses. Results Compared to healthy controls, patients with chronic, unexplained fatigue rated themselves as more active before their illness (p ≤ 0.001 and less active currently (p ≤ 0.001. The patients also reported they currently stood or walked less than the controls (median [inter-quartile range] = 4 2345 versus 9 [7.5–12] hours, p ≤ 0.001, and spent more time reclining (median [inter-quartile range] = 12 10111213141516 versus 8 [8–9.5] hours, p ≤ 0.001. These differences remained significant for the subset of patients who met strict criteria for chronic fatigue syndrome or fibromyalgia. Conclusion Patients with chronic, unexplained, disabling fatigue reported being more active before becoming ill than healthy controls. This finding could be explained by greater premorbid activity levels that could predispose to illness, or by an overestimation of previous activity. Either possibility could influence patients' perceptions of their current activity levels and their judgments of recovery. Perceived activity should be addressed as part of management of the illness.

  15. Dehydroepiandrosterone (DHEA) substitution treatment for severe fatigue in DHEA-deficient patients with primary Sjögren's syndrome.

    Science.gov (United States)

    Virkki, Liisa M; Porola, Pauliina; Forsblad-d'Elia, Helena; Valtysdottir, Sigridur; Solovieva, Svetlana A; Konttinen, Yrjö T

    2010-01-15

    Primary Sjögren's syndrome (SS) is characterized by fatigue and low levels of serum dehydroepiandrosterone/dehydroepiandrosterone sulfate (DHEA/DHEAS). Our aim was to study whether SS patients with severe fatigue and low serum DHEAS values benefit from DHEA substitution (50 mg/day). A multicenter, investigator-based, powered, randomized controlled clinical trial (crossover, washout design) using fatigue as the primary outcome measure was performed on patients with primary SS (n = 107) who had a general fatigue score > or =14 on the 20-item Multiple Fatigue Inventory (MFI-20), combined with age- and sex-adjusted serum DHEAS values below the mean. Fatigue was assessed using MFI-20 subscales, i.e., general fatigue, physical fatigue, mental fatigue, reduced motivation, and activity (scale 4-20), and with a visual analog scale (VAS; scale 0-100). In an intent-to-treat analysis, a 50-mg DHEA substitution dose and placebo similarly improved fatigue. All of the MFI-20 subscales and the fatigue VAS improved from the baseline levels as a result of treatment (P DHEA in DHEA-deficient and severely tired primary SS patients does not help against fatigue better than placebo. This may relate to the prohormone nature of DHEA and its recently described defective intracrine tissue-specific conversion to active sex steroids in SS.

  16. The Significance of Dehydroepiandrosterone for Fatigue in primary Sjögren’s Syndrome and Systemic Lupus Erythematosus

    NARCIS (Netherlands)

    Hartkamp, A.

    2014-01-01

    Fatigue is a prevalent and debilitating symptom in patients with the chronic inflammatory autoimmune diseases primary Sjögren’s syndrome (pSS) and systemic lupus erythematosus (SLE). Both diseases have a female preponderance (women to men ratio 9:1). Doctors recognize the existence of fatigue and

  17. The Significance of Dehydroepiandrosterone for Fatigue in primary Sjögren’s Syndrome and Systemic Lupus Erythematosus

    NARCIS (Netherlands)

    Hartkamp, A.

    2014-01-01

    Fatigue is a prevalent and debilitating symptom in patients with the chronic inflammatory autoimmune diseases primary Sjögren’s syndrome (pSS) and systemic lupus erythematosus (SLE). Both diseases have a female preponderance (women to men ratio 9:1). Doctors recognize the existence of fatigue and it

  18. The genetics and epigenetics of fatigue.

    Science.gov (United States)

    Landmark-Høyvik, Hege; Reinertsen, Kristin V; Loge, Jon H; Kristensen, Vessela N; Dumeaux, Vanessa; Fosså, Sophie D; Børresen-Dale, Anne-Lise; Edvardsen, Hege

    2010-05-01

    Fatigue is a common symptom and includes both physical and mental components. It can be associated with a variety of different syndromes and diseases, but in many cases is not associated with other comorbid conditions. Most humans have experienced acute fatigue in relation to different stressors. Acute fatigue typically decreases as the effect of the triggering factor is reduced and a normal homeostatic balance is restored. Fatigue that persists for 6 months or more is termed chronic fatigue. Chronic fatigue (CF) in combination with a minimum of 4 of 8 symptoms and the absence of diseases that could explain these symptoms, constitute the case definition for chronic fatigue syndrome. In spite of its prevalence, the biology of fatigue is relatively poorly understood and biological markers have not yet been identified. This literature search was performed in PubMed to identify research on the genetics and epigenetics of fatigue. Publications were included if fatigue was a major topic and the topic was combined with genetic and/or epigenetic measurements in adult humans. A total of 40 publications were identified. Although altered functioning in the hypothalamic-pituitary-adrenal axis, the serotonergic system, and associations with infectious agents have been identified, the search for genetic or epigenetic markers of fatigue, either in the context of CF or chronic fatigue syndrome (CFS) has been relatively unproductive or, in the case of epigenetics, nonexistent. Although several studies, both hypothesis-testing and hypothesis-generating, have been performed to search for biomarkers, they have mostly been underpowered, restricted by the heterogeneity of the phenotype, or limited by an unsystematic study design. To be able to confirm the hypothesis that risk for, or levels of, fatigue are influenced by the genetic or epigenetic background of an individual, studies need to be based on larger sample sizes with a more clearly defined phenotype. Studies need to focus not

  19. Cognitive behavioural therapy versus multidisciplinary rehabilitation treatment for patients with chronic fatigue syndrome: study protocol for a randomised controlled trial (FatiGo)

    NARCIS (Netherlands)

    Vos-Vromans, D.C.; Smeets, R.J.P.; Rijnders, L.J.; Gorrissen, R.R.; Pont, M.; Koke, A.J.; Hitters, M.W.; Evers, S.M.; Knottnerus, A.J.

    2012-01-01

    ABSTRACT: BACKGROUND: Patients with chronic fatigue syndrome experience extreme fatigue, which often leads to substantial limitations of occupational, educational, social and personal activities. Currently, there is no consensus regarding the treatment. Patients try many different therapies to overc

  20. Cognitive behavioural therapy versus multidisciplinary rehabilitation treatment for patients with chronic fatigue syndrome: study protocol for a randomised controlled trial (FatiGo)

    NARCIS (Netherlands)

    Vos-Vromans, D.C.; Smeets, R.J.P.; Rijnders, L.J.; Gorrissen, R.R.; Pont, M.; Koke, A.J.; Hitters, M.W.; Evers, S.M.; Knottnerus, A.J.

    2012-01-01

    ABSTRACT: BACKGROUND: Patients with chronic fatigue syndrome experience extreme fatigue, which often leads to substantial limitations of occupational, educational, social and personal activities. Currently, there is no consensus regarding the treatment. Patients try many different therapies to

  1. Restless leg syndrome, sleep quality and fatigue in multiple sclerosis patients

    Directory of Open Access Journals (Sweden)

    N.C.V. Moreira

    2008-10-01

    Full Text Available We have tested the hypothesis that restless leg syndrome (RLS is related to quality of sleep, fatigue and clinical disability in multiple sclerosis (MS. The diagnosis of RLS used the four minimum criteria defined by the International Restless Legs Syndrome Study Group. Fatigue was assessed by the Fatigue Severity Scale (FSS >27, quality of sleep by the Pittsburgh Sleep Quality Index (PSQI >6, excessive daytime sleepiness by the Epworth Sleepiness Scale (ESS >10 and clinical disability by the Expanded Disability Status Scale (EDSS. Forty-four patients (32 women aged 14 to 64 years (43 ± 14 with disease from 0.4 to 23 years (6.7 ± 5.9 were evaluated. Thirty-five were classified as relapsing-remitting, 5 as primary progressive and 4 as secondary progressive. EDSS varied from 0 to 8.0 (3.6 ± 2.0. RLS was detected in 12 cases (27%. Patients with RLS presented greater disability (P = 0.01, poorer sleep (P = 0.02 and greater levels of fatigue (P = 0.03. Impaired sleep was present in 23 (52% and excessive daytime sleepiness in 3 cases (6.8%. Fatigue was present in 32 subjects (73% and was associated with clinical disability (P = 0.000 and sleep quality (P = 0.002. Age, gender, disease duration, MS pattern, excessive daytime sleepiness and the presence of upper motor neuron signs were not associated with the presence of RLS. Fatigue was best explained by clinical disability and poor sleep quality. Awareness of RLS among health care professionals may contribute to improvement in MS management.

  2. Subclinical Sjögren's syndrome and anti-Ro/SSA-positive autoimmune fatigue syndrome in children.

    Science.gov (United States)

    Itoh, Y; Imai, T; Fujino, O; Igarashi, T; Fukunaga, Y

    2002-09-01

    Abstract Although Sjögren's syndrome (SS) is quite rare among children, subclinical conditions without any sicca symptoms have been reported. This condition is characterized by nonspecific rheumatic symptoms and histopathological findings in salivary glands which are equivalent to SS. Many children with subclinical SS are positive for anti-Ro/SSA. On the other hand, autoimmune fatigue syndrome (AIFS) is characterized by chronic nonspecific complaints and positive antinuclear antibodies, with or without fulfilling the criteria for chronic fatigue syndrome. Although a novel autoantibody against a 62 kD nuclear protein (anti-Sa) is detected in about 40% of AIFS patients, few marker antibodies for autoimmune diseases, such as anti-DNA, anti-Sm, anti-U1-ribonucleoprotein (RNP), or anticardiolipin, are found in AIFS patients. In this study, however, anti-Ro/SSA was detected in sera from 8 out of 122 AIFS patients. Seven of the 8 anti-Ro/SSA-positive patients were female. All 8 patients had fatigue and low-grade fever, but none complained of xerosis. Western immunoblot analysis revealed that 7 sera reacted with Ro52, and that none was positive for anti-La/SSB or anti-Sa. Two of the 8 patients had histories of recurrent parotitis. Lip biopsies showed mild chronic inflammation compatible with subclinical SS in these 2 patients, although the other 6 patients had no abnormal histopathology. Thus, at least some anti-Ro/SSA-positive patients could be diagnosed as having SS.

  3. Increased concentrations of homocysteine in the cerebrospinal fluid in patients with fibromyalgia and chronic fatigue syndrome.

    Science.gov (United States)

    Regland, B; Andersson, M; Abrahamsson, L; Bagby, J; Dyrehag, L E; Gottfries, C G

    1997-01-01

    Twelve outpatients, all women, who fulfilled the criteria for both fibromyalgia and chronic fatigue syndrome were rated on 15 items of the Comprehensive Psychopathological Rating Scale (CPRS-15). These items were chosen to constitute a proper neurasthenic subscale. Blood laboratory levels were generally normal. The most obvious finding was that, in all the patients, the homocysteine (HCY) levels were increased in the cerebrospinal fluid (CSF). There was a significant positive correlation between CSF-HCY levels and fatiguability, and the levels of CSF-B12 correlated significantly with the item of fatiguability and with CPRS-15. The correlations between vitamin B12 and clinical variables of the CPRS-scale in this study indicate that low CSF-B12 values are of clinical importance. Vitamin B12 deficiency causes a deficient remethylation of HCY and is therefore probably contributing to the increased homocysteine levels found in our patient group. We conclude that increased homocysteine levels in the central nervous system characterize patients fulfilling the criteria for both fibromyalgia and chronic fatigue syndrome.

  4. Yang/Qi Invigoration: An Herbal Therapy for Chronic Fatigue Syndrome with Yang Deficiency?

    Directory of Open Access Journals (Sweden)

    Pou Kuan Leong

    2015-01-01

    Full Text Available According to traditional Chinese medicine (TCM theory, Yang and Qi are driving forces of biological activities in the human body. Based on the crucial role of the mitochondrion in energy metabolism, we propose an extended view of Yang and Qi in the context of mitochondrion-driven cellular and body function. It is of interest that the clinical manifestations of Yang/Qi deficiencies in TCM resemble those of chronic fatigue syndrome in Western medicine, which is pathologically associated with mitochondrial dysfunction. By virtue of their ability to enhance mitochondrial function and its regulation, Yang- and Qi-invigorating tonic herbs, such as Cistanches Herba and Schisandrae Fructus, may therefore prove to be beneficial in the treatment of chronic fatigue syndrome with Yang deficiency.

  5. Treatment of Guillain-Barré syndrome and causes and treatment of residual fatigue

    OpenAIRE

    Garssen, Marcel

    2005-01-01

    textabstractChapter 1 is the general introduction of this thesis, in which di.erent aspects of the Guillain-Barré syndrome (GBS) are described. GBS is an acute post-infectious polyneuropathy, in which the immune system plays an important role. Insight in pathogenesis, clinical and electrophysiological features, functional outcome, and residual complaints is increasing. To date, fatigue is considered one of the most disabling residual symptoms, seriously a.ecting quality of life. The considera...

  6. Replication of an empirical approach to delineate the heterogeneity of chronic unexplained fatigue

    Directory of Open Access Journals (Sweden)

    White Peter D

    2009-10-01

    Full Text Available Abstract Background Chronic fatigue syndrome (CFS is defined by self-reported symptoms. There are no diagnostic signs or laboratory markers, and the pathophysiology remains inchoate. In part, difficulties identifying and replicating biomarkers and elucidating the pathophysiology reflect the heterogeneous nature of the syndromic illness CFS. We conducted this analysis of people from defined metropolitan, urban, and rural populations to replicate our earlier empirical delineation of medically unexplained chronic fatigue and CFS into discrete endophenotypes. Both the earlier and current analyses utilized quantitative measures of functional impairment and symptoms as well as laboratory data. This study and the earlier one enrolled participants from defined populations and measured the internal milieu, which differentiates them from studies of clinic referrals that examine only clinical phenotypes. Methods This analysis evaluated 386 women identified in a population-based survey of chronic fatigue and unwellness in metropolitan, urban, and rural populations of the state of Georgia, USA. We used variables previously demonstrated to effectively delineate endophenotypes in an attempt to replicate identification of these endophenotypes. Latent class analyses were used to derive the classes, and these were compared and contrasted to those described in the previous study based in Wichita, Kansas. Results We identified five classes in the best fit analysis. Participants in Class 1 (25% were polysymptomatic, with sleep problems and depressed mood. Class 2 (24% was also polysymptomatic, with insomnia and depression, but participants were also obese with associated metabolic strain. Class 3 (20% had more selective symptoms but was equally obese with metabolic strain. Class 4 (20% and Class 5 (11% consisted of nonfatigued, less symptomatic individuals, Class 4 being older and Class 5 younger. The classes were generally validated by independent variables. People

  7. Evaluation of Intelligence Structure and Diffusion Tensor Imaging MRI in Children with Chronic Fatigue Syndrome%慢性疲劳综合征患儿的智力结构评估及弥散张量成像研究

    Institute of Scientific and Technical Information of China (English)

    孙瑄; 张燕; 陶庆玲; 程卫华; 艾林

    2012-01-01

    目的:研究慢性疲劳综合征(CFS)患儿与正常对照儿童智力结构的差异,并且采用弥散张量成像(DTI)技术观察2者白质纤维的差异.方法:CFS患儿27例为CFS组,27例与CFS组基本匹配的健康志愿者为对照组.所有被试者首先进行韦氏智力测验(C-WISC),计算言语智商(VIQ)、操作智商(PIQ)、总智商(FIQ)、记忆/不分心(M/C)因子等,其后行DTI扫描,采用基于像素的分析方法比较2组的部分各项异性(FA)值.结果:CFS组FIQ、VIQ和PIQ都在正常水平,与对照组差异无统计学意义,CFS组M/C因子低于对照组(P<0.0083).CFS组右侧胼周额部深部白质(PCF)及左侧视放射(OR)FA值显著低于对照组.结论:CFS患儿存在短时记忆以及注意缺陷,PCF及OR功能缺陷可能与其智力结构缺陷有关.%Objective: To assess the structure of intelligence and explore the changes of white mater (WM) in children with chronic fatigue syndrome (CFS) using diffusion tensor imaging (DTI) examination. Methods: Twenty-seven CFS children (CFS group) and 27 healthy controls (control group) were recruited. Firstly, intelligence tests were performed using Wechsler Intelligence Scale-Revised China (C-WISC) in the CFS patients and controls. The full intelligence quotient (FIQ) , verbal IQ (VIQ), performance IQ (PIQ) and memory/caution (M/C) factor were measured. After intelligence tests, DTI scans were performed. Voxel-wise statistical analysis of the fractional anisotropy (FA) data was carried out to investigate differences between 2 groups. Results: The FIQ, VIQ and PIQ in the CFS group were within the normal range and did not significantly differ from those in the control group. The M/C factor was statistically lower in the CFS group. Compared with the controls, the CFS patients had lower FA in WM fiber tracts of right pericallosal frontal (PCF) and left optic radiation. Conclusion: Impairment in memory/ caution is evident in the CFS children, and the impaired density or

  8. The effect of ondansetron, a 5-HT3 receptor antagonist, in chronic fatigue syndrome: a randomized controlled trial.

    Science.gov (United States)

    The, Gerard K H; Bleijenberg, Gijs; Buitelaar, Jan K; van der Meer, Jos W M

    2010-05-01

    Accumulating data support the involvement of the serotonin (5-hydroxytryptamine [5-HT]) system in the pathophysiology of chronic fatigue syndrome. Neuropharmacologic studies point to a hyperactive 5-HT system, and open-label treatment studies with 5-HT(3) receptor antagonists have shown promising results. In this randomized controlled clinical trial, the effect of ondansetron, a 5-HT(3) receptor antagonist, was assessed on fatigue severity and functional impairment in adult patients with chronic fatigue syndrome. A randomized, placebo-controlled, double-blind clinical trial was conducted at Radboud University Nijmegen Medical Centre, The Netherlands. Sixty-seven adult patients who fulfilled the US Centers for Disease Control and Prevention (CDC) criteria for chronic fatigue syndrome and who were free from current psychiatric comorbidity participated in the clinical trial. Participants received either ondansetron 16 mg per day or placebo for 10 weeks. The primary outcome variables were fatigue severity (Checklist Individual Strength fatigue severity subscale [CIS-fatigue]) and functional impairment (Sickness Impact Profile-8 [SIP-8]). The effect of ondansetron was assessed by analysis of covariance. Data were analyzed on an intention-to-treat basis. All patients were recruited between June 2003 and March 2006. Thirty-three patients were allocated to the ondansetron condition, 34 to the placebo condition. The 2 groups were well matched in terms of age, sex, fatigue severity, functional impairment, and CDC symptoms. Analysis of covariance showed no significant differences between the ondansetron- and placebo-treated groups during the 10-week treatment period in fatigue severity and functional impairment. This clinical trial demonstrates no benefit of ondansetron compared to placebo in the treatment of chronic fatigue syndrome. www.trialregister.nl: ISRCTN02536681. ©Copyright 2010 Physicians Postgraduate Press, Inc.

  9. Impact of restless legs syndrome in patients with inflammatory bowel disease on sleep, fatigue, and quality of life.

    Science.gov (United States)

    Schindlbeck, Katharina A; Becker, Janek; Berger, Felix; Mehl, Arne; Rewitzer, Charlotte; Geffe, Sarah; Koch, Peter M; Preiß, Jan C; Siegmund, Britta; Maul, Jochen; Marzinzik, Frank

    2017-01-01

    Inflammatory bowel disease has been associated with neurological symptoms including restless legs syndrome. Here, we investigated the impact of restless legs syndrome in patients with inflammatory bowel disease on sleep, fatigue, mood, cognition, and quality of life. Two groups of inflammatory bowel disease patients, with and without restless legs syndrome, were prospectively evaluated for sleep disorders, fatigue, daytime sleepiness, depression, anxiety, and health-related quality of life. Furthermore, global cognitive function, executive function, attention, and concentration were assessed in both groups. Disease activity and duration of inflammatory bowel disease as well as current medication were assessed by interview. Inflammatory bowel disease patients with and without restless legs syndrome were matched for age, education, severity, and duration of their inflammatory bowel disease. Patients with inflammatory bowel disease and clinically relevant restless leg syndrome suffered significantly more frequent from sleep disturbances including sleep latency and duration, more fatigue, and worse health-related quality of life as compared to inflammatory bowel disease patients without restless legs syndrome. Affect and cognitive function including cognitive flexibility, attention, and concentration showed no significant differences among groups, indicating to be not related to restless legs syndrome. Sleep disorders including longer sleep latency, shorter sleep duration, and fatigue are characteristic symptoms of restless legs syndrome in inflammatory bowel disease patients, resulting in worse health-related quality of life. Therefore, clinicians treating patients with inflammatory bowel disease should be alert for restless legs syndrome.

  10. A study of median frequencies of skeletal muscle undergoing Tuina intervention in patients with chronic fatigue syndrome%推拿干预慢性疲劳综合征患者骨骼肌中位频率的临床研究

    Institute of Scientific and Technical Information of China (English)

    刘鲲鹏; 房敏; 戴德纯; 姜淑云; 左亚忠

    2011-01-01

    目的:观察推拿干预慢性疲劳综合征(chronic fatigue syndrome,CFS)患者四肢及腰背骨骼肌后,其表面肌电中位频率(median frequency,MF)及疲劳量表评分的变化.方法:采用临床对照试验,2010年3月~2011年2月选取上海中医药大学附属岳阳中西医结合医院慢性疲劳综合征专科门诊就诊的CFS患者(32人),并选择30名正常人做对照.对CFS患者推拿治疗20 d.推拿前后检测CFS患者四肢及腰背骨骼肌表面肌电MF,并采用慢性病功能评价量表进行疲劳评价.结果:CFS患者四肢骨骼肌MF值与正常人比较差异无统计学意义,腰背肌MF值高于正常人(P<0.05);CFS患者推拿后的疲劳量表评分明显低于治疗前.结论:CFS患者腰背肌肌纤维MF高于正常人,推拿能改善CFS患者的疲劳症状.%Objective: To study the changes in median frequency (MF) from a surface electromyogram of skeletal musclesand functional assessment of chronic illness therapy (FACIT) figure scale scores for patients with chronicfatigue syndrome (CFS) before and after Tuina treatment.Methods: A controlled clinical trial was adopted. Thirty-two patients suffering from CFS were enrolled accordingto the inclusion criteria from outpatient department of Shanghai Yueyang Hospital of Integrated Chinese andWestern Medicine in China; thirty normal people whose gender, age, height and body mass were concordantwith the CFS patients were selected as the normal group. Surface electromyography was used to detect themedian frequency (MF) of biceps, quadriceps, and waist and back muscle before and after a 20-day courseof treatment. CFS patients also were asked to fill out the figure scale of FACIT to evaluate the degree offatigue.Results; There was no significant difference in surface electromyography MF of myoelectric signal of bicepsand quadriceps between CFS and normal person; however, the waist and back muscle MF of the normalperson was significantly lower than that of the CFS patients

  11. 南昌市小学教师慢性疲劳综合征及相关因素%Chronic fatigue syndrome and related factors among primary school teachers in Nanchang City

    Institute of Scientific and Technical Information of China (English)

    余超; 吴磊; 阎冀; 江涵; 张欣; 刘月圆; 侯良

    2012-01-01

    Objective: To understand the present epidemic status and distributional characteristics of the chronic fatigue syndrome (CFS) in primary school teachers in Nanchang. Methods: Altogether, 934 teachers were selected from 10 primary schools in Nanchang City, and 893 effective questionnaires were returned. The sample consisted of 341 aged below 30 years, 333 aged 30 - 39,135 aged 40 -49, and 84 aged 50 or above. The 9 items CFS self-assessment scale was developed, according to the 9 symptoms specified in the revised diagnostic criterion of the US Centers for Disease Control and Prevention in 1994. Participants were assessed with the CFS self-assessment scale and the self-made questionnaires for demographic information and CFS related factors. Then psychosomatic medicine doctors in affiliated hospital of Nanchang University followed up every suspected patients to make a definite diagnosis. Results: The rate of CFS was 12. 9% (95% CI: 10. 7% ~ 15. 1 % ), and the rates of the 4 age groups were 8. 8% , 15. 0% , 14. 1% , and 19. 0% respectively (x2 =7. 37, P <0.05). No significant difference was found in the rates between different genders. Multivariate logistic regression analysis showed that aged 50 or above (Oft = 2. 44), having strained relationship with students'parents (OR =6. 36) were risk factors for CFS, and higher satisfaction about working environment (OR =0.64), various recreational activities (OR =0.15), always seeking help from others when experiencing troubles (OR = 0. 73) were protective factors. Conclusion: It suggests that the detection rate of CFS is quite high among primary school teachers, with a rising trend with the age increasing. It is helpful to improve teachers-stuilents'parents relationships, working environment, recreational activities and trouble releasing for reducing the rate of chronic fatigue syndrome.%目的:了解南昌市小学教师慢性疲劳综合征(CFS)的流行现状和分布特征,探索CFS的相关因素.方法:采用分

  12. Mental Fatigue and Executive Dysfunction in Patients with Cushing's Syndrome in Remission.

    Science.gov (United States)

    Papakokkinou, Eleni; Johansson, Birgitta; Berglund, Peter; Ragnarsson, Oskar

    2015-01-01

    Patients with Cushing's syndrome (CS) in remission often suffer from impaired quality of life and cognitive dysfunction. The primary aim was to investigate the occurrence of mental fatigue, characterized by mental exhaustion and long recovery time following mentally strenuous tasks, in patients with CS in remission. The secondary aim was to examine whether the newly developed parts C and D of the trail making test (TMT) are more sensitive, compared to the conventional parts A and B, to evaluate attention and executive function. This was a cross-sectional study including 51 patients with CS in remission and 51 controls. All subjects completed the self-administrated mental fatigue scale (MFS) and performed all four parts of the TMT. The patients had worse outcome on all components of the MFS except for sensitivity to noise. After adjustment for mental fatigue, depression, and anxiety, the patients performed worse only on part D of the TMT (P Mental fatigue is common in patients with CS in remission and can be captured by using the MFS. The most demanding part of the TMT, part D, is more useful to capture cognitive deficits in patients with CS in remission compared to the conventional parts A and B.

  13. The factors associated with the burnout syndrome and fatigue in Cypriot nurses: a census report

    Science.gov (United States)

    2012-01-01

    Background Fatigue and burnout are two concepts often linked in the literature. However, regardless of their commonalities they should be approached as distinct concepts. The current and ever-growing reforms regarding the delivery of nursing care in Cyprus, stress for the development of ways to prevent burnout and effectively manage fatigue that can result from working in stressful clinical environments. Methods To explore the factors associated with the burnout syndrome in Cypriot nurses working in various clinical departments. A random sampling method taking into account geographical location, specialty and type of employment has been used. Results A total of 1,482 nurses (80.4% were females) working both in the private and public sectors completed and returned an anonymous questionnaire that included several aspects related to burnout; the MBI scale, questions related to occupational stress, and questions pertaining to self reported fatigue. Two-thirds (65.1%) of the nurses believed that their job is stressful with the majority reporting their job as stressful being female nurses (67.7%). Twelve point eight percent of the nurses met Maslach’s criteria for burnout. The prevalence of fatigue in nurses was found 91.9%. The prevalence of fatigue was higher in females (93%) than in males (87.5%) (p = 0.003). As opposed to the burnout prevalence, fatigue prevalence did not differ among the nursing departments (p = 0.166) and among nurses with a different marital status (p = 0.553). Burnout can be associated adequately knowing if nurses find their job stressful, their age, the level of emotional exhaustion and depersonalization. It has been shown that the fatigue may be thought of as a predictor of burnout, but its influence is already accounted by emotional exhaustion and depersonalization. Conclusion The clinical settings in Cyprus appear as stress generating environment for nurses. Nurses working both in the private and public sector appear to

  14. A controlled study of the effect of a mindfulness-based stress reduction technique in women with multiple chemical sensitivity, chronic fatigue syndrome, and fibromyalgia

    Directory of Open Access Journals (Sweden)

    Tara Sampalli

    2009-04-01

    Full Text Available Tara Sampalli1, Elizabeth Berlasso1, Roy Fox1, Mark Petter21Nova Scotia Environmental Health Centre, Fall River, Nova Scotia, Canada; 2Doctoral Candidate, Department of Psychology, Dalhousie University, Halifax, CanadaBackground: The objective of this study was to examine the effect of a mindfulness-based stress reduction (MBSR program on women diagnosed with conditions such as multiple chemical sensitivity (MCS, chronic fatigue syndrome (CFS, and fibromyalgia (FM. Methods: The intervention group underwent a 10-week MBSR program. Symptoms Checklist Inventory (SCL-90R was used as outcome measure and was administered before the start of the program (pre-, immediately upon completion (post- and at three-month follow-up. Women on the wait list to receive treatment at the Nova Scotia Environmental Health Centre were used as control subjects for the study.Results: A total of 50 participants in the intervention group and 26 in the wait-list controls group were recruited for this study. Global scores in the intervention group reached statistical significance pre-post (<0.0001 and at pre-follow-up (<0.0001 while the global scores in the control group remained the same. Five of nine and eight of nine subscales of the SCL-90R showed improvement of statistical significance in MBSR group following treatment and at three-month follow-up.Conclusions: The study showed the importance of complementary interventions such as MBSR techniques in the reduction of psychological distress in women with chronic conditions.Keywords: chronic conditions, multiple chemical sensitivity, mindfulness-based stress reduction, chemical sensitivity

  15. Chronic fatigue in patients with unexplained self-reported food hypersensitivity and irritable bowel syndrome: validation of a Norwegian translation of the Fatigue Impact Scale

    Directory of Open Access Journals (Sweden)

    Lind R

    2013-07-01

    Full Text Available Ragna Lind,1 Arnold Berstad,2 Jan Hatlebakk,1,3 Jørgen Valeur21Department of Medicine, Haukeland University Hospital, Bergen, 2Unger-Vetlesen Institute, Department of Medicine, Lovisenberg Diakonale Hospital, Oslo, 3Department of Clinical Medicine, University of Bergen, Bergen, NorwayBackground: Patients with unexplained self-reported food hypersensitivity and irritable bowel syndrome (IBS suffer from several health complaints, including fatigue. The aim of the present study was to validate a Norwegian translation of the Fatigue Impact Scale (FIS, and to assess the impact of fatigue in patients with self-reported food hypersensitivity and IBS, as compared with healthy controls.Methods: Thirty-eight patients with unexplained self-reported food hypersensitivity and IBS, who participated in the validation of the FIS completed the following additional questionnaires: the Short Form of Nepean Dyspepsia Index for assessment of quality of life, the Subjective Health Complaint Inventory, and questionnaires for diagnosis and severity of IBS. Impact of fatigue was studied in 43 patients with unexplained self-reported food hypersensitivity, 70% diagnosed with IBS, and 42 healthy controls.Results: Cronbach's α for the FIS was 0.98, indicating excellent agreement between individual items. Scores on the FIS correlated with scores on the Short Form of Nepean Dyspepsia Index (r = 0.50, P = 0.001, indicating good convergent validity, and were higher in patients (median 85.0, interquartile range 36.8–105.3 than in controls (median 14.0, interquartile range 3.0–29.0, P ≤0.0001.Conclusion: The Norwegian translation of the FIS performed excellently in patients with unexplained self-reported food hypersensitivity and IBS, with patients reporting significantly more impact of chronic fatigue than healthy controls.Keywords: irritable bowel syndrome, fatigue, food hypersensitivity, quality of life

  16. Therapeutic effect of extract of Oenanthe Javanica against the chronic fatigue syndrome in mice%水芹提取物对应激致小鼠慢性疲劳综合征的对抗作用

    Institute of Scientific and Technical Information of China (English)

    苏成虎; 陈晓农; 杨新波; 黄正明; 曹文斌; 陈红艳

    2012-01-01

    Objective: To explore the role and the mechanism of the extract of Oenanthe Javanica (OJE) against the CFS in mice. Methods: We prepared the stressed CFS model by forcing mice swimming in cold water. From the perspective of stressed, we observed the general behavior of every mouse, function of the axis of Hypothalamus-Pituitary-Adrenal and the energy metabolism in skeletal muscle, and then made a further explore for the mechanism of the treatment of chronic fatigue syndrome. Results: The results showed that cold water stress can significantly decrease the locomotor activity of mice, the levels of ACTH, CORT in the serum of the axis of Hypothalamus-Pituitary-Adrenal significantly were increased, the level of sex hormone testosterone was decreased, the levels of 5-HT, DA of central neurotransmitters were significantly increased, the vitality of Ca2+-Mg2+-ATP enzyme was decreased, the level of Pi was significantly increased, the level of Radical such as MDA significantly was increased, the vitality of SOD significantly was decreased. After OJE's treatment, the locomotor activity of mice was significantly increased, function of the axis of Hypothalamus-Pituitary-Adrenal and Gonadal axis returned to normal, the level of central neurotransmitters was decreased, situation of peripheral fatigue was improved, the level of radical was back to normal. Conclusion: OJE can significantly therapy the chronic fatigue syndrome in mice caused by chronic stress.%目的:观察水芹提取物对应激致小鼠慢性疲劳综合征(CFS)的对抗作用及其相关机制.方法:采用强制冷水游泳应激法制备CFS模型,从应激角度,观察应激导致动物疲劳时,其大体行为学、下丘脑—垂体—肾上腺轴(HPA轴)功能变化、中枢神经递质的变化以及骨骼肌能量代谢指标,并进一步探讨水芹提取物治疗慢性疲劳的机制.结果:冷水应激使小鼠自主活动明显下降;HPA轴功能指标:血清促肾上腺皮质激素(ACTH)、皮质

  17. A four-year follow-up study in fibromyalgia. Relationship to chronic fatigue syndrome

    DEFF Research Database (Denmark)

    Nørregaard, J; Bülow, P M; Prescott, E

    1993-01-01

    The primary objectives of this study were to examine to what extent fibromyalgia patients later on developed presumpted causative somatic diseases and to examine symptoms and muscle strength some years after the diagnosis of fibromyalgia was established. A secondary objective was to describe...... the overlap between fibromyalgia and chronic fatigue syndrome. Only in two of 91 the muscle pain was found to be caused by another somatic disease during the median 4 year follow-up period. In one of the 83 attending subjects a somatic disease associated with muscle symptoms was established at the follow...

  18. A role for the body burden of aluminium in vaccine-associated macrophagic myofasciitis and chronic fatigue syndrome.

    Science.gov (United States)

    Exley, Christopher; Swarbrick, Louise; Gherardi, Rhomain K; Authier, Francois-Jérôme

    2009-02-01

    Macrophagic myofasciitis and chronic fatigue syndrome are severely disabling conditions which may be caused by adverse reactions to aluminium-containing adjuvants in vaccines. While a little is known of disease aetiology both conditions are characterised by an aberrant immune response, have a number of prominent symptoms in common and are coincident in many individuals. Herein, we have described a case of vaccine-associated chronic fatigue syndrome and macrophagic myofasciitis in an individual demonstrating aluminium overload. This is the first report linking the latter with either of these two conditions and the possibility is considered that the coincident aluminium overload contributed significantly to the severity of these conditions in this individual. This case has highlighted potential dangers associated with aluminium-containing adjuvants and we have elucidated a possible mechanism whereby vaccination involving aluminium-containing adjuvants could trigger the cascade of immunological events which are associated with autoimmune conditions including chronic fatigue syndrome and macrophagic myofasciitis.

  19. Less efficient and costly processes of frontal cortex in childhood chronic fatigue syndrome

    Directory of Open Access Journals (Sweden)

    Kei Mizuno

    2015-01-01

    Full Text Available The ability to divide one's attention deteriorates in patients with childhood chronic fatigue syndrome (CCFS. We conducted a study using a dual verbal task to assess allocation of attentional resources to two simultaneous activities (picking out vowels and reading for story comprehension and functional magnetic resonance imaging. Patients exhibited a much larger area of activation, recruiting additional frontal areas. The right middle frontal gyrus (MFG, which is included in the dorsolateral prefrontal cortex, of CCFS patients was specifically activated in both the single and dual tasks; this activation level was positively correlated with motivation scores for the tasks and accuracy of story comprehension. In addition, in patients, the dorsal anterior cingulate gyrus (dACC and left MFG were activated only in the dual task, and activation levels of the dACC and left MFG were positively associated with the motivation and fatigue scores, respectively. Patients with CCFS exhibited a wider area of activated frontal regions related to attentional resources in order to increase their poorer task performance with massive mental effort. This is likely to be less efficient and costly in terms of energy requirements. It seems to be related to the pathophysiology of patients with CCFS and to cause a vicious cycle of further increases in fatigue.

  20. Less efficient and costly processes of frontal cortex in childhood chronic fatigue syndrome.

    Science.gov (United States)

    Mizuno, Kei; Tanaka, Masaaki; Tanabe, Hiroki C; Joudoi, Takako; Kawatani, Junko; Shigihara, Yoshihito; Tomoda, Akemi; Miike, Teruhisa; Imai-Matsumura, Kyoko; Sadato, Norihiro; Watanabe, Yasuyoshi

    2015-01-01

    The ability to divide one's attention deteriorates in patients with childhood chronic fatigue syndrome (CCFS). We conducted a study using a dual verbal task to assess allocation of attentional resources to two simultaneous activities (picking out vowels and reading for story comprehension) and functional magnetic resonance imaging. Patients exhibited a much larger area of activation, recruiting additional frontal areas. The right middle frontal gyrus (MFG), which is included in the dorsolateral prefrontal cortex, of CCFS patients was specifically activated in both the single and dual tasks; this activation level was positively correlated with motivation scores for the tasks and accuracy of story comprehension. In addition, in patients, the dorsal anterior cingulate gyrus (dACC) and left MFG were activated only in the dual task, and activation levels of the dACC and left MFG were positively associated with the motivation and fatigue scores, respectively. Patients with CCFS exhibited a wider area of activated frontal regions related to attentional resources in order to increase their poorer task performance with massive mental effort. This is likely to be less efficient and costly in terms of energy requirements. It seems to be related to the pathophysiology of patients with CCFS and to cause a vicious cycle of further increases in fatigue.

  1. Core Flight Software (CFS) Maturation Towards Human Rating Project

    Data.gov (United States)

    National Aeronautics and Space Administration — The Core Flight Software (CFS) system developed by Goddard Space Flight Center, through experience on Morpheus, has proven to be a quality product and a viable...

  2. A High-Order CFS Algorithm for Clustering Big Data

    OpenAIRE

    Fanyu Bu; Zhikui Chen; Peng Li; Tong Tang; Ying Zhang

    2016-01-01

    With the development of Internet of Everything such as Internet of Things, Internet of People, and Industrial Internet, big data is being generated. Clustering is a widely used technique for big data analytics and mining. However, most of current algorithms are not effective to cluster heterogeneous data which is prevalent in big data. In this paper, we propose a high-order CFS algorithm (HOCFS) to cluster heterogeneous data by combining the CFS clustering algorithm and the dropout deep learn...

  3. Mark Twain and his family's health: Livy Clemens' neurasthenia in the gilded age and chronic fatigue syndrome of today.

    Science.gov (United States)

    Arcari, Ralph; Crombie, H David

    2003-05-01

    Our purpose is to compare and contrast the 19th century diagnosis and disease neurasthenia with the contemporary illness known as Chronic Fatigue Syndrome. The health of Mark Twain's wife, Olivia (Livy) Clemens, will then be discussed and evaluated with respect to these two medical conditions.

  4. The effect of ondansetron, a 5-HT3 receptor antagonist, in chronic fatigue syndrome: a randomized controlled trial.

    NARCIS (Netherlands)

    The, G.K.H.; Bleijenberg, G.; Buitelaar, J.K.; Meer, J.W.M. van der

    2010-01-01

    BACKGROUND: Accumulating data support the involvement of the serotonin (5-hydroxytryptamine [5-HT]) system in the pathophysiology of chronic fatigue syndrome. Neuropharmacologic studies point to a hyperactive 5-HT system, and open-label treatment studies with 5-HT(3) receptor antagonists have shown

  5. Evaluating Interactive Fatigue Management Workshops for Occupational Health Professionals in the United Kingdom

    Directory of Open Access Journals (Sweden)

    Sheila Ali

    2014-12-01

    Conclusion: Fatigue can lead to severe functional impairment with adverse workplace outcomes. One-day workshops can be effective in training OH professionals in how to diagnose and manage fatigue and CFS. Training may increase general knowledge of fatigue and confidence in fatigue management in an OH setting.

  6. Low putamen activity associated with poor reward sensitivity in childhood chronic fatigue syndrome.

    Science.gov (United States)

    Mizuno, Kei; Kawatani, Junko; Tajima, Kanako; Sasaki, Akihiro T; Yoneda, Tetsuya; Komi, Masanori; Hirai, Toshinori; Tomoda, Akemi; Joudoi, Takako; Watanabe, Yasuyoshi

    2016-01-01

    Motivational signals influence a wide variety of cognitive processes and components of behavioral performance. Cognitive dysfunction in patients with childhood chronic fatigue syndrome (CCFS) may be closely associated with a low motivation to learn induced by impaired neural reward processing. However, the extent to which reward processing is impaired in CCFS patients is unclear. The aim of the present functional magnetic resonance imaging (fMRI) study was to determine whether brain activity in regions related to reward sensitivity is impaired in CCFS patients. fMRI data were collected from 13 CCFS patients (mean age, 13.6 ± 1.0 years) and 13 healthy children and adolescents (HCA) (mean age, 13.7 ± 1.3 years) performing a monetary reward task. Neural activity in high- and low-monetary-reward conditions was compared between CCFS and HCA groups. Severity of fatigue and the reward obtained from learning in daily life were evaluated by questionnaires. Activity of the putamen was lower in the CCFS group than in the HCA group in the low-reward condition, but not in the high-reward condition. Activity of the putamen in the low-reward condition in CCFS patients was negatively and positively correlated with severity of fatigue and the reward from learning in daily life, respectively. We previously revealed that motivation to learn was correlated with striatal activity, particularly the neural activity in the putamen. This suggests that in CCFS patients low putamen activity, associated with altered dopaminergic function, decreases reward sensitivity and lowers motivation to learn.

  7. Low putamen activity associated with poor reward sensitivity in childhood chronic fatigue syndrome

    Directory of Open Access Journals (Sweden)

    Kei Mizuno, Ph.D.

    2016-01-01

    Full Text Available Motivational signals influence a wide variety of cognitive processes and components of behavioral performance. Cognitive dysfunction in patients with childhood chronic fatigue syndrome (CCFS may be closely associated with a low motivation to learn induced by impaired neural reward processing. However, the extent to which reward processing is impaired in CCFS patients is unclear. The aim of the present functional magnetic resonance imaging (fMRI study was to determine whether brain activity in regions related to reward sensitivity is impaired in CCFS patients. fMRI data were collected from 13 CCFS patients (mean age, 13.6 ± 1.0 years and 13 healthy children and adolescents (HCA (mean age, 13.7 ± 1.3 years performing a monetary reward task. Neural activity in high- and low-monetary-reward conditions was compared between CCFS and HCA groups. Severity of fatigue and the reward obtained from learning in daily life were evaluated by questionnaires. Activity of the putamen was lower in the CCFS group than in the HCA group in the low-reward condition, but not in the high-reward condition. Activity of the putamen in the low-reward condition in CCFS patients was negatively and positively correlated with severity of fatigue and the reward from learning in daily life, respectively. We previously revealed that motivation to learn was correlated with striatal activity, particularly the neural activity in the putamen. This suggests that in CCFS patients low putamen activity, associated with altered dopaminergic function, decreases reward sensitivity and lowers motivation to learn.

  8. Self-Reported Migraine and Chronic Fatigue Syndrome Are More Prevalent in People with Myofascial vs Nonmyofascial Temporomandibular Disorders.

    Science.gov (United States)

    Dahan, Haissam; Shir, Yoram; Nicolau, Belinda; Keith, David; Allison, Paul

    2016-01-01

    To compare the number of comorbidities and the prevalence of five specific comorbidities in people who have temporomandibular disorders (TMD) with or without myofascial pain. This cross-sectional study included 180 patients seeking TMD treatment in Boston and Montreal hospitals. A self-administered questionnaire was used to collect information on sociodemographic and behavioral factors, as well as the presence of the following five comorbidities: migraine, chronic fatigue syndrome, irritable bowel syndrome, interstitial cystitis, and restless leg syndrome. TMD was diagnosed using the Research Diagnostic Criteria for TMD. Chi-square and Student t tests were used for categorical and continuous variables, respectively, to test for differences between myofascial (n = 121) and nonmyofascial (n = 59) TMD groups. Multiple logistic regression analysis was used to compare the type and number of self-reported comorbidities in both groups, controlling for confounding variables. The following were found to be significantly higher in the myofascial TMD group than in the nonmyofascial TMD group: self-reported migraine (55% vs 28%, P = .001), chronic fatigue syndrome (19% vs 5%, P = .01), and the mean total number of comorbidities (1.30 vs 0.83, P = .01). Individuals with myofascial TMD had a higher prevalence of self-reported migraine and chronic fatigue syndrome than those with nonmyofascial TMD.

  9. Exposing Compassion Fatigue and Burnout Syndrome in a Trauma Team: A Qualitative Study.

    Science.gov (United States)

    Berg, Gina M; Harshbarger, Jenni L; Ahlers-Schmidt, Carolyn R; Lippoldt, Diana

    2016-01-01

    Compassion fatigue (CF) and burnout syndrome (BOS) are identified in trauma, emergency, and critical care nursing practices. The purpose of this qualitative study was to measure CF and BOS in a trauma team and allow them to share perceptions of related stress triggers and coping strategies. Surveys to measure CF and BOS and a focus group allowed a trauma team (12 practitioners) to share perceptions of related stress triggers and coping strategies. More than half scored at risk for CF and BOS. Stress triggers were described as situation (abuse, age of patient) versus injury-related. Personal coping mechanisms were most often reported. Both CF and BOS can be assessed with a simple survey tool. Strategies for developing a program culturally sensitive to CF and BOS are provided.

  10. 76 FR 42128 - Solicitation of Nominations for Appointment to the Chronic Fatigue Syndrome Advisory Committee

    Science.gov (United States)

    2011-07-18

    ... implications of current and proposed diagnosis and treatment methods for CFS; (3) development and... consists of 11 members. The Committee is composed of seven biomedical research scientists with demonstrated... individual's curriculum vitae or resume. Nominations that do not provide these three elements will not...

  11. Identity and coping experiences in Chronic Fatigue Syndrome: a synthesis of qualitative studies

    DEFF Research Database (Denmark)

    Larun, L.; Malterud, K.

    2007-01-01

    -order constructs from a line of arguments. RESULTS: Twenty qualitative studies on CFS experiences were identified. Symptom experiences and the responses from significant others could jeopardise the patients' senses of identity. They felt severely ill, yet blamed and dismissed. Patients' beliefs and causal...

  12. 疲劳性亚健康不同中医证候人群疲劳特点的研究%Study on fatigue characteristics in people with fatigue-predominant sub-health based on different TCM syndromes

    Institute of Scientific and Technical Information of China (English)

    薛晓琳; 王天芳; 韩萍; 王佳佳; 李冠儒; 张雅静

    2011-01-01

    [目的]探讨疲劳性亚健康不同中医证候人群的疲劳特点.[方法]依据相关标准对疲劳性亚健康人群进行中医辨证,并按照一定原则对辨证结果进行归类;采用疲劳自评量表(FSAS)对不同证候类型的疲劳性亚健康人群的疲劳进行量化评定,并通过统计软件对其测量结果进行分析.[结果]躯体疲劳分值、总体疲劳分值各组无统计学差异,精神疲劳分值、疲劳后果、疲劳对睡眠/休息的反应、疲劳的情境性分组各组人群均有统计学差异(P<0.05).[结论]1)疲劳性亚健康不同证候人群的疲劳状况存在差异.2)肝郁脾虚证人群的躯体疲劳表现、精神疲劳和总体疲劳较其他证候人群明显,尤其精神疲劳表现较其他人群突出,疲劳对其生活、工作的影响也较为明显;阴虚证类精神疲劳、总体表现及疲劳对生活、工作造成的影响均不明显.3)疲劳特征方面:阳气虚证类人群的睡眠/休息不能缓解疲劳的状况最为突出;肝气郁结证人群的疲劳最易受到环境和情绪的影响而加重或减轻.%[Objective]To explore the fatigue characteristics in people with fatigue-predominant sub-health based on TCM syndrome.[Methods]Referring to related standards of TCM, the differentiations of TCM was performed and in accordance with the definite principle the differentiated results were classified.Using serf-evaluating criteria (FSAS) the fatigue degree for fatigue was quantified in each patient with fatigued sub-health status.Fatigue was assessed in all of people using fatigue serf-assessment scale and fatigue characteristics were analyzed among different people by statistics software.[Results]In addition to physical fatigue factor score, fatigue consequences factor score, and other factors scores are different among different people based on TCM syndromes (P<0.05).[Conclusion]l)Different people with fatigue-predominant sub-health based on different TCM syndromes have

  13. Determinants of fatigue and stress

    Directory of Open Access Journals (Sweden)

    Brähler Elmar

    2011-07-01

    Full Text Available Abstract Background Fatigue can be triggered by previous perceived stress which may lead to impairment of performance and function. The purpose of the study was to investigate the relationship between fatigue and perceived stress. Method Health determinants including sociodemographic factors for associations between fatigue and perceived stress in the general population (N = 2,483 are outlined. Fatigue and stress were assessed with the Chalder Fatigue Scale (CFS and the Perceived Stress Questionnaire (PSQ. Results Within the general population, 25.9% of male and 34.5% of female respondents reported moderate fatigue during the last six months; 9.7% of subjects reported substantial fatigue lasting six months or longer. An adjusted regression analysis (R2corr = .28, p Conclusion We conclude that the two conditions overlap most in terms of socio-economic status and self-perceived health status.

  14. Effect of dehydroepiandrosterone administration on fatigue, well-being, and functioning in women with primary Sjogren syndrome : a randomised controlled trial

    NARCIS (Netherlands)

    Hartkamp, A.; Geenen, R.; Godaert, G. L. R.; Bootsma, H.; Kruize, A. A.; Bijlsma, J. W. J.; Derksen, R. H. W. M.

    Objective: Dehydroepiandrosterone (DHEA) administration has been reported to improve fatigue, psychological distress, and physical disability. These are common features of primary Sjogren syndrome (pSS). We investigated the effects of DHEA administration on fatigue, well-being, and functioning in

  15. Effect of dehydroepiandrosterone administration on fatigue, well-being, and functioning in women with primary Sjogren syndrome : a randomised controlled trial

    NARCIS (Netherlands)

    Hartkamp, A.; Geenen, R.; Godaert, G. L. R.; Bootsma, H.; Kruize, A. A.; Bijlsma, J. W. J.; Derksen, R. H. W. M.

    2008-01-01

    Objective: Dehydroepiandrosterone (DHEA) administration has been reported to improve fatigue, psychological distress, and physical disability. These are common features of primary Sjogren syndrome (pSS). We investigated the effects of DHEA administration on fatigue, well-being, and functioning in wo

  16. Protocol for the PACE trial: a randomised controlled trial of adaptive pacing, cognitive behaviour therapy, and graded exercise, as supplements to standardised specialist medical care versus standardised specialist medical care alone for patients with the chronic fatigue syndrome/myalgic encephalomyelitis or encephalopathy.

    Science.gov (United States)

    White, Peter D; Sharpe, Michael C; Chalder, Trudie; DeCesare, Julia C; Walwyn, Rebecca

    2007-03-08

    Chronic fatigue syndrome (CFS, also called myalgic encephalomyelitis /encephalopathy or ME) is a debilitating condition with no known cause or cure. Improvement may occur with medical care and additional therapies of pacing, cognitive behavioural therapy and graded exercise therapy. The latter two therapies have been found to be efficacious in small trials, but patient organisations surveys have reported adverse effects. Although pacing has been advocated by patient organisations, it lacks empirical support. Specialist medical care is commonly provided but its efficacy when given alone is not established. This trial compares the efficacy of the additional therapies when added to specialist medical care against specialist medical care alone. 600 patients, who meet operationalised diagnostic criteria for CFS, will be recruited from secondary care into a randomised trial of four treatments, stratified by current co morbid depressive episode and different CFS/ME criteria. The four treatments are standardised specialist medical care either given alone, or with adaptive pacing therapy or cognitive behaviour therapy or graded exercise therapy. Supplementary therapies will involve fourteen sessions over 23 weeks and a booster session at 36 weeks. Outcome will be assessed at 12, 24, and 52 weeks after randomisation. Two primary outcomes of self-rated fatigue and physical function will assess differential effects of each treatment on these measures. Secondary outcomes include adverse events and reactions, subjective measures of symptoms, mood, sleep and function and objective measures of physical activity, fitness, cost-effectiveness and cost-utility. The primary analysis will be based on intention to treat and will use logistic regression models to compare treatments. Secondary outcomes will be analysed by repeated measures analysis of variance with a linear mixed model. All analyses will allow for stratification factors. Mediators and moderators will be explored using

  17. Protocol for the PACE trial: A randomised controlled trial of adaptive pacing, cognitive behaviour therapy, and graded exercise as supplements to standardised specialist medical care versus standardised specialist medical care alone for patients with the chronic fatigue syndrome/myalgic encephalomyelitis or encephalopathy

    Directory of Open Access Journals (Sweden)

    DeCesare Julia C

    2007-03-01

    Full Text Available Abstract Background Chronic fatigue syndrome (CFS, also called myalgic encephalomyelitis/encephalopathy or ME is a debilitating condition with no known cause or cure. Improvement may occur with medical care and additional therapies of pacing, cognitive behavioural therapy and graded exercise therapy. The latter two therapies have been found to be efficacious in small trials, but patient organisations' surveys have reported adverse effects. Although pacing has been advocated by patient organisations, it lacks empirical support. Specialist medical care is commonly provided but its efficacy when given alone is not established. This trial compares the efficacy of the additional therapies when added to specialist medical care against specialist medical care alone. Methods/Design 600 patients, who meet operationalised diagnostic criteria for CFS, will be recruited from secondary care into a randomised trial of four treatments, stratified by current comorbid depressive episode and different CFS/ME criteria. The four treatments are standardised specialist medical care either given alone, or with adaptive pacing therapy or cognitive behaviour therapy or graded exercise therapy. Supplementary therapies will involve fourteen sessions over 23 weeks and a 'booster session' at 36 weeks. Outcome will be assessed at 12, 24, and 52 weeks after randomisation. Two primary outcomes of self-rated fatigue and physical function will assess differential effects of each treatment on these measures. Secondary outcomes include adverse events and reactions, subjective measures of symptoms, mood, sleep and function and objective measures of physical activity, fitness, cost-effectiveness and cost-utility. The primary analysis will be based on intention to treat and will use logistic regression models to compare treatments. Secondary outcomes will be analysed by repeated measures analysis of variance with a linear mixed model. All analyses will allow for stratification

  18. A control study of duloxetine vs .paroxetine in the treatment of chronic fatigue syndrome%度洛西汀与帕罗西汀治疗慢性疲劳综合征对照研究

    Institute of Scientific and Technical Information of China (English)

    王刚平; 颉瑞

    2013-01-01

    目的探讨度洛西汀与帕罗西汀治疗慢性疲劳综合征的临床疗效和安全性。方法将58例慢性疲劳综合征患者随机分为两组,每组29例,分别口服度洛西汀和帕罗西汀治疗,观察8周。采用疲劳量表-14、抑郁自评量表、焦虑自评量表和副反应量表评定临床疗效和不良反应。结果治疗后两组疲劳量表-14、抑郁自评量表、焦虑自评量表评分均较治疗前显著下降( P<0.01),度洛西汀组较帕罗西汀组下降更显著( P<0.05或0.01);治疗8周末度洛西汀组显效率(82.8%)显著高于帕罗西汀组(58.6%)(χ2=4.08,P<0.05);两组不良反应均轻微,发生率比较差异无显著性(P>0.05)。结论度洛西汀与帕罗西汀治疗慢性疲劳综合征疗效均显著,安全性高,但度洛西汀起效更快,疗效更好,优于帕罗西汀治疗。%Objective To explore the efficacy and safety of duloxetine vs .paroxe-tine in the treatment of chronic fatigue syndrome (CFS ) .Methods Fifty-eight CFS patients were randomly divided into two groups of 29 ones each taking orally duloxetine and paroxetine respectively for 8 weeks .Efficacies were assessed with the Fatigue Scale-14 (FS-14) ,Self-rating Depression Scale (SDS) and Self-rating Anxiety Scale (SAS) , and adverse reactions with the Treatment Emergent Symptom Scale (TESS) .Results The FS-14 ,SDS and SAS scores of both groups lowered more significantly after treatment compared with pretreatment (P0 .05) .Conclusion Both duloxetine and paroxetine have an evident effect and higher safe-ty in the treatment of chronic fatigue syndrome ,but the former takes effect more rapidly and has a more evident effect .

  19. A High-Order CFS Algorithm for Clustering Big Data

    Directory of Open Access Journals (Sweden)

    Fanyu Bu

    2016-01-01

    Full Text Available With the development of Internet of Everything such as Internet of Things, Internet of People, and Industrial Internet, big data is being generated. Clustering is a widely used technique for big data analytics and mining. However, most of current algorithms are not effective to cluster heterogeneous data which is prevalent in big data. In this paper, we propose a high-order CFS algorithm (HOCFS to cluster heterogeneous data by combining the CFS clustering algorithm and the dropout deep learning model, whose functionality rests on three pillars: (i an adaptive dropout deep learning model to learn features from each type of data, (ii a feature tensor model to capture the correlations of heterogeneous data, and (iii a tensor distance-based high-order CFS algorithm to cluster heterogeneous data. Furthermore, we verify our proposed algorithm on different datasets, by comparison with other two clustering schemes, that is, HOPCM and CFS. Results confirm the effectiveness of the proposed algorithm in clustering heterogeneous data.

  20. Psychological profiles in patients with Sjogren's syndrome related to fatigue : a cluster analysis

    NARCIS (Netherlands)

    van Leeuwen, Ninke; Bossema, Ercolie R.; Knoop, Hans; Kruize, Aike A.; Bootsma, Hendrika; Bijlsma, Johannes W. J.; Geenen, Rinie

    2015-01-01

    Objective. Fatigue is a highly prevalent and debilitating symptom in the autoimmune disease SS. Although the disease process plays a role in fatigue, psychological factors may influence fatigue and the ability to deal with its consequences. Profiles of co-occurring psychological factors may suggest

  1. Os peroneum friction syndrome complicated by sesamoid fatigue fracture: a new radiological diagnosis? Case report and literature review

    Energy Technology Data Exchange (ETDEWEB)

    Bashir, Waseem A.; Connell, David A. [Royal National Orthopaedic Hospital NHS Trust, Department of Radiology, London, Middlesex (United Kingdom); Lewis, Steve [Craven Cottage, Fulham Football Club, London (United Kingdom); Cullen, Nicholas [The Royal National Orthopaedic Hospital NHS Trust, Department of Orthopaedics, London, Middlesex (United Kingdom)

    2009-02-15

    Injuries to the peroneal tendons are relatively common worldwide but tendon rupture without significant trauma is uncommon. Ankle mechanics can be seriously affected by disruption of one or both of the peroneal tendons although complete rupture can also remain asymptomatic. Accessory ossicles are sesamoid bones and are common findings in routine radiology of the foot and ankle. Although in the vast majority these ''os'' are normal variants of anatomy, they can lead to painful syndromes and suffer fractures and even undergo degenerative changes in response to overuse and trauma. Although similar syndromes have been discussed in the surgical literature, there is a lack of literature describing the use of modern imaging in the accurate diagnosis and its subsequent assistance towards appropriate management of os peroneum friction syndrome complicated by sesamoid fatigue syndrome. This article presents the plain film, sonographic and magnetic resonance imaging findings in a case of os peroneum friction syndrome complicated by a sesamoid fatigue fracture as well as reviewing the pertinent literature. (orig.)

  2. Management of pain and fatigue in the joint hypermobility syndrome (a.k.a. Ehlers-Danlos syndrome, hypermobility type): principles and proposal for a multidisciplinary approach.

    Science.gov (United States)

    Castori, Marco; Morlino, Silvia; Celletti, Claudia; Celli, Mauro; Morrone, Aldo; Colombi, Marina; Camerota, Filippo; Grammatico, Paola

    2012-08-01

    Joint hypermobility syndrome (JHS), or Ehlers-Danlos syndrome (EDS) hypermobility type (EDS-HT), is a underdiagnosed heritable connective tissue disorder characterized by generalized joint hypermobility and a wide range of visceral, pelvic, neurologic, and cognitive dysfunctions. Deterioration of quality of life is mainly associated with pain and fatigue. Except for the recognized effectiveness of physiotherapy for some musculoskeletal features, there are no standardized guidelines for the assessment and treatment of pain and fatigue. In this work, a practical classification of pain presentations and factors contributing in generating painful sensations in JHS/EDS-HT is proposed. Pain can be topographically classified in articular limb (acute/subacute and chronic), muscular limb (myofascial and fibromyalgia), neuropathic limb, back/neck, abdominal and pelvic pain, and headache. For selected forms of pain, specific predisposing characteristics are outlined. Fatigue appears as the result of multiple factors, including muscle weakness, respiratory insufficiency, unrefreshing sleep, dysautonomia, intestinal malabsorption, reactive depression/anxiety, and excessive use of analgesics. A set of lifestyle recommendations to instruct patients as well as specific investigations aimed at characterizing pain and fatigue are identified. Available treatment options are discussed in the set of a structured multidisciplinary approach based on reliable outcome tools.

  3. Burnout: evaluation of the efficacy and tolerability of TARGET 1® for professional fatigue syndrome (burnout).

    Science.gov (United States)

    Jacquet, Alain; Grolleau, Adeline; Jove, Jérémy; Lassalle, Régis; Moore, Nicholas

    2015-02-01

    To study the effect of a dietary supplement (TARGET 1®: a combination of casozepine, taurine, Eleutherococcus senticosus and extramel) on burnout symptomatology. A 12-week, double-blind, randomized, placebo-controlled trial was conducted in workers engaged in professional contact with patients, students or clients. All were affected by burnout syndrome based on a score of ≥4 on the Burnout Measure Scale (BMS-10). The primary outcome measure was the change in the BMS-10 score; secondary outcome measures included the change in the Maslach's Burnout Inventory scale-Human Service Survey (MBI-HSS) score and the Beck Depression Inventory. Five scores were evaluated. Eighty-seven participants were enrolled in the study: 44 received the active formulation (verum group); 43 received placebo. After 12 weeks' supplementation, the placebo group showed significant improvements in scores for BMS-10, MBI-HSS fatigue and the Beck Depression Inventory, but MBI-HSS depersonalization and task management were not improved; the verum group showed significant improvements in all five scores. The verum group consistently showed significantly greater improvements in scores than the placebo group. TARGET 1® significantly improved the symptoms of burnout after 12 weeks' use. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  4. Severe versus Moderate Criteria for the New Pediatric Case Definition for ME/CFS

    Science.gov (United States)

    Jason, Leonard; Porter, Nicole; Shelleby, Elizabeth; Till, Lindsay; Bell, David S.; Lapp, Charles W.; Rowe, Kathy; De Meirleir, Kenny

    2009-01-01

    The new diagnostic criteria for pediatric ME/CFS are structurally based on the Canadian Clinical Adult case definition, and have more required specific symptoms than the (Fukuda et al. Ann Intern Med 121:953-959, 1994) adult case definition. Physicians specializing in pediatric ME/CFS referred thirty-three pediatric patients with ME/CFS and 21…

  5. 药浴疗法对慢性疲劳综合征的干预研究%Effects of traditional Chinese medical herbs bath in the treatment of chronic fatigue syndrome

    Institute of Scientific and Technical Information of China (English)

    孔筠; 郝淑玲; 王丛妙; 王卫香; 李德俊

    2012-01-01

    Objective To observe the therapy effect of Traditional Chinese Medicine (TCM)bath in patients with Chronic Fatigue Syndrome(CFS).Methods A total of 212 patients with CFS characterized by stagnation of liver-Qi with deficiency of the spleen were randomly assigned into TCM group(n =106),control group(n =50)and Xiaoyaowan group(n =54).Patients in the TCM group were treated with Chinese herbal bath ;control group were treated with lemon yellow,once every other day for 4 weeks and Xiaoyaowan group were taken orally with dosage of eight pills every time,twice a day.The effects of TCM bath were evaluated by using TCM Symptom Table,Pittsburgh Sleep Quality Index questionnaire (PSQ1)and simple symptom scale.Results The main positive symptoms' scores of TCM symptom table were lower after TCM bath treatment,as compared with those in control group(P < 0.05).The ratio of sickness curative effect in TCM group and Xiaoyaowan group was higher than that in control group (P <0.01).Conclusions TCM herbs bath may attenuate the syndrome of CFS.It is sugested that TCM herbs bath is a new approach to treat CFS.%目的 观察中医疏肝健脾药浴疗法对肝郁脾虚型慢性疲劳综合征(CFS)的干预效果.方法 228例肝郁脾虚型慢性疲劳综合征患者依据随机表,受试者按2:1:1比例分为3组,研究中缺失16例,最终212例患者符合要求,药浴组(106例)、逍遥丸组(56例)、对照组(50例).药浴组采用疏肝健脾中药配方进行药浴干预,4周为1个疗程;对照组给予安慰剂(食品色素柠檬黄)对照,隔日1次,4周为1个疗程;逍遥丸组口服逍遥丸8粒/次,2次/d.采用中医证候量表、匹兹堡睡眠质量指数、简易症状量表等作为观察指标,综合评价药浴疗法对CFS的干预效果.实验数据以(x)±s表示,组间比较用方差分析,方差不齐时采用K-W 和LSD秩和检验.均数比较用t检验.结果 干预后药浴组患者中医症候主要阳性症状评分明显优于干预前.3组中

  6. 运动干预对大鼠慢性疲劳综合征形成的影响%Influence of Motion Intervention on the Formation of Chronic Fatigue Syndrome Rats

    Institute of Scientific and Technical Information of China (English)

    孟昭琴; 司绪岚; 房冬梅

    2012-01-01

    目的:通过研究游泳运动对大鼠慢性疲劳综合征形成的干预作用及对γ-干扰素、白介素4等指标的影响,为防治CFS提供分子学方面的依据。方法:将50只8周龄Wister雄性大鼠,随机分为实验组和对照组。实验结束24 h后处死。取2-3 mL的血液低温离心分离血清于-20℃冰箱中储存备用待测皮质醇和血睾酮;取3-4 mL的血液低温离心分离血清,置于4℃冰箱中保存待测INF-γ和IL-4。结果:1)采用慢性束缚方法复制的动物模型血清睾酮值、胸腺重量非常显著性降低,皮质酮值非常显著性升高。2)不同时间的游泳对慢性束缚大鼠产生的效果不同,与模型对照组相比:(1)30 min游泳组和60 min游泳组的体重、力竭时间依次为非常显著性升高和显著性升高,血清睾酮及胸腺重量显著性升高,皮质酮值显著降低;(2)慢性束缚+力竭游泳组体重、力竭时间、血清睾酮和胸腺重量有降低趋势,皮质酮有升高趋势。3)慢性束缚可使大鼠的IFN-γ的含量非常显著性降低;4)慢性束缚可使大鼠的IL-4的含量降低,但效果不显著;各组之间无显著性差异。结论:1)慢性束缚可以成功复制慢性疲劳综合征大鼠模型。2)30min、60 min游泳特别是30 m游泳的干预作用可有效预防CFS的发生。3)30 m、60 m游泳都可以调节大鼠FIN-γ的分泌,使IFN-γ/IL-4、比率正向变化,有效预防大鼠CFS的形成。%Objective: This experiment of swimming research on chronic fatigue syndrome can learn the intervention of chronic fatigue syndrome and the influence of interferon-γ and IL-4.It can provide molecular basis for preventing CFS.Method: 50 eight-week-old male Wister rats were randomly divided into experimental group and control group.And they were killed 24h after the experiment finished.Take 2~3ml centrifuge low blood serum stored at-20 ℃ refrigerator spare blood cortisol and testosterone

  7. Temporal organization of rest defined by actigraphy data in healthy and childhood chronic fatigue syndrome children.

    Science.gov (United States)

    Kawabata, Minako; Ueno, Taro; Tomita, Jun; Kawatani, Junko; Tomoda, Akemi; Kume, Shoen; Kume, Kazuhiko

    2013-11-04

    Accumulating evidence has shown a universality in the temporal organization of activity and rest among animals ranging from mammals to insects. Previous reports in both humans and mice showed that rest bout durations followed long-tailed (i.e., power-law) distributions, whereas activity bouts followed exponential distributions. We confirmed similar results in the fruit fly, Drosophila melanogaster. Conversely, another report showed that the awakening bout durations, which were defined by polysomnography in bed, followed power-law distributions, while sleeping periods, which may correspond to rest, followed exponential distributions. This apparent discrepancy has been left to be resolved. Actigraphy data from healthy and disordered children were analyzed separately for two periods: time out of bed (UP period) and time in bed (DOWN period). When data over a period of 24 h were analyzed as a whole, rest bouts showed a power law distribution as previously reported. However, when UP and DOWN period data were analyzed separately, neither showed power law properties. Using a newly developed strict method, only 30% of individuals satisfied the power law criteria, even when the 24 h data were analyzed. The human results were in contrast to the Drosophila results, which revealed clear power-law distributions for both day time and night time rest through the use of a strict method. In addition, we analyzed the actigraphy data from patients with childhood type chronic fatigue syndrome (CCFS), and found that they showed differences from healthy controls when their UP and DOWN data were analyzed separately. These results suggested that the DOWN sleep, the bout distribution of which showed exponential properties, contributes to the production of long-tail distributions in human rest periods. We propose that separate analysis of UP and DOWN period data is important for understanding the temporal organization of activity.

  8. Effect of Acupuncture on Serum Malonaldehyde Content, Superoxide Dismutase and Glutathione Peroxidase Activity in Chronic Fatigue Syndrome Rats%针刺对慢性疲劳综合征大鼠血清丙二醛含量及超氧化物歧化酶、谷胱甘肽过氧化物酶活性的影响

    Institute of Scientific and Technical Information of China (English)

    刘长征; 雷波

    2012-01-01

    目的:探讨针刺治疗慢性疲劳综合征(CFS)的作用机制.方法:将雄性SD大鼠随机分为空白对照组、模型组、针刺组,每组10只.采用慢性多重复合应激法制备大鼠CFS模型.针刺组针刺双侧“足三里“三阴交”穴,留针20 min,每日1次,7次为1个疗程,休息3d后行下一疗程,共3个疗程.采用硫代巴比妥酸比色法检测各组大鼠血清丙二醛(MDA)含量,黄嘌呤氧化酶法检测超氧化物歧化酶(SOD)活性,二硫基双硝基苯甲酸法检测谷胱甘肽过氧化物酶(GSH-PX)活性.结果:模型组大鼠血清中MDA含量高于空白对照组(P<0.01),SOD、GSH-PX活性低于空白对照组(P<0.01);针刺组大鼠血清中MDA含量低于模型组(P<0.01),SOD、GSH-PX活性高于模型组(P<0.01).结论:针刺可提高CFS大鼠抗氧化能力,针刺治疗CFS的作用机制可能与调节大鼠氧自由基代谢有关.%Objective To study the effect of acupuncture on blood oxygen free radical metabolism in rats with chronic fatigue syndrome (CFS). Methods Thirty male SD rats were randomly divided into control group (n = 10), model group (n= 10) and acupuncture group (n = 10). CFS model was established by repeated suspension (1. 0-2. 5 h) and forced cold water swimming (7min), once daily continuously for 12 days. For rats in the acupuncture group, bilateral "Zusanli" (ST 36) and "Sanyinjiao" (SP 6) were stimulated by manipulating the acupuncture needles intermittently for 20 min, once daily, and with 7 days being a treatment course. The treatment was conducted for three courses with an interval of 3 days between two courses. Serum malonaldehyde (MDA) content, superoxide dismutase (SOD) activity, and glutathione peroxidase (GSH-PX) activity were detected by thiobarbituric acid chromatometry (TBA), xanthine oxidase (XOD) and dithio-bis-nitrobenzoic acid (DTNB), respectively. Results In comparison with the control group, serum MDA content was up-regulated significantly, while serum SOD

  9. Work participation in adults with Marfan syndrome: Demographic characteristics, MFS related health symptoms, chronic pain, and fatigue.

    Science.gov (United States)

    Velvin, Gry; Bathen, Trine; Rand-Hendriksen, Svend; Geirdal, Amy Østertun

    2015-12-01

    Marfan syndrome (MFS) is a severe autosomal dominant connective tissue disorder that might influence peoples work ability. This cross sectional study aims to investigate work participation in adults with verified MFS diagnosis and to explore how the health related consequences of MFS and other factors might influence work participation. The prevalence of health problems in young adults compared to older adults with MFS was examined in association to work participation. A postal questionnaire including questions about work participation, demographic characteristics, MFS related health problems, chronic pain, and fatigue was sent to 117 adults with verified MFS (Ghent 1), and 62% answered. Fifty-nine percent were employed or students, significantly lower work participation than the General Norwegian Population (GNP), but higher than the Norwegian population of people with disability. Most young adults worked full-time despite extensive health problems, but the average age for leaving work was low. Few had received any work adaptations prior to retiring from work. In multiple logistic regression analysis, only age, lower educational level and severe fatigue were significantly associated with low work participation; not MFS related health problems or chronic pain. Fatigue appears to be the most challenging health problem to deal with in work, but the covariance is complex. Focus on vocational guidance early in life, more appropriate work adaptations, and psychosocial support might improve the possibility for sustaining in work for adults with MFS. More research about work challenges in adults with MFS is needed.

  10. Further validation of the Multidimensional Fatigue Inventory in a US adult population sample

    Directory of Open Access Journals (Sweden)

    BeLue Rhonda

    2009-12-01

    Full Text Available Abstract Background The Multidimensional Fatigue Inventory (MFI-20 was developed in 1995. Since then, it has been widely used in cancer research and cancer-related illnesses but has never been validated in fatiguing illnesses or in a large US population-selected sample. In this study, we sought to examine the reliability and validity of the MFI-20 in the population of the state of Georgia, USA. Further, we assessed whether the MFI-20 could serve as a complementary diagnostic tool in chronically fatigued and unwell populations. Methods The data derive from a cross-sectional population-based study investigating the prevalence of chronic fatigue syndrome (CFS in Georgia. The study sample was comprised of three diagnostic groups: CFS-like (292, chronically unwell (269, and well (222. Participants completed the MFI-20 along with several other measures of psychosocial functioning, including the Medical Outcomes Survey Short Form-36 (SF-36, the Zung Self-Rating Depression Scale (SDS, and the Spielberger State-Trait Anxiety Inventory (STAI. We assessed the five MFI-20 subscales using several criteria: inter-item correlations, corrected item-total correlations, internal consistency reliability (Cronbach's alpha coefficients, construct validity, discriminant (known-group validity, floor/ceiling effects, and convergent validity through correlations with the SF-36, SDS, and STAI instruments. Results Averaged inter-item correlations ranged from 0.38 to 0.61, indicating no item redundancy. Corrected item-total correlations for all MFI-20 subscales were greater than 0.30, and Cronbach's alpha coefficients achieved an acceptable level of 0.70. No significant floor/ceiling effect was observed. Factor analysis demonstrated factorial complexity. The MFI-20 also distinguished clearly between three diagnostic groups on all subscales. Furthermore, correlations with depression (SDS, anxiety (STAI, and functional impairment (SF-36 demonstrated strong convergent

  11. Cognitive behavioural therapy versus multidisciplinary rehabilitation treatment for patients with chronic fatigue syndrome: study protocol for a randomised controlled trial (FatiGo

    Directory of Open Access Journals (Sweden)

    Vos-Vromans Desirée CWM

    2012-05-01

    Full Text Available Abstract Background Patients with chronic fatigue syndrome experience extreme fatigue, which often leads to substantial limitations of occupational, educational, social and personal activities. Currently, there is no consensus regarding the treatment. Patients try many different therapies to overcome their fatigue. Although there is no consensus, cognitive behavioural therapy is seen as one of the most effective treatments. Little is known about multidisciplinary rehabilitation treatment, a combination of cognitive behavioural therapy with principles of mindfulness, gradual increase of activities, body awareness therapy and pacing. The difference in effectiveness and cost-effectiveness between multidisciplinary rehabilitation treatment and cognitive behavioural therapy is as yet unknown. The FatiGo (Fatigue-Go trial aims to compare the effects of both treatment approaches in outpatient rehabilitation on fatigue severity and quality of life in patients with chronic fatigue syndrome. Methods One hundred twenty patients who meet the criteria of chronic fatigue syndrome, fulfil the inclusion criteria and sign the informed consent form will be recruited. Both treatments take 6 months to complete. The outcome will be assessed at 6 and 12 months after the start of treatment. Two weeks after the start of treatment, expectancy and credibility will be measured, and patients will be asked to write down their personal goals and score their current performance on these goals on a visual analogue scale. At 6 and 14 weeks after the start of treatment, the primary outcome and three potential mediators—self-efficacy, causal attributions and present-centred attention-awareness—will be measured. Primary outcomes are fatigue severity and quality of life. Secondary outcomes are physical activity, psychological symptoms, self-efficacy, causal attributions, impact of disease on emotional and physical functioning, present-centred attention-awareness, life

  12. The effects of fatigue and the post-concussion syndrome on executive functioning in traumatic brain injury and healthy comparisons

    Directory of Open Access Journals (Sweden)

    Enid Schutte

    2010-03-01

    n Vergelykingsmonster van 15 deelnemers met geen geskiedenis van kopbeserings is deur dieselfde metodologie uitgeput. Alle uitgeputte deelnemers (met en sonder TKB het ’n neiging na verhoogde vlakke van perseverasie en verminderde induktiewe redenering op die WCST getoon. Die impak van uitputting op hoëvlak-funksionering is dus verreikend, selfs in gevalle waar geen kopbesering opgedoen is nie. Die bevinding ondersteun suboptimale prestasie in kognitiewe vaardighede, en spesifiek in uitvoerende beheer, wat dikwels onder uitgeputte mense gevind word. Hierdie bevindinge is van belang vir die manier waarop rehabilitasie-intervensies en regsgeneeskundige assesserings gestruktureer word. Die volgorde van toetse, die interpretasie daarvan en die rusperiodes moet duidelik in assesseringsverslae en rehabilitasiesessies aangetoon en geïnterpreteer word.

    How to cite this article:Fry, J.D., Greenop, K.,Schutte, E. ‘The effects of fatigue and the postconcussion syndrome on executive functioning in traumatic brain injury and healthy comparisons’,Health SA Gesondheid15(1, Art. #541, 8 pages.DOI: 10.4102/hsag.v15i1.541

  13. Postural Orthostatic Tachycardia With Chronic Fatigue After HPV Vaccination as Part of the "Autoimmune/Auto-inflammatory Syndrome Induced by Adjuvants": Case Report and Literature Review.

    Science.gov (United States)

    Tomljenovic, Lucija; Colafrancesco, Serena; Perricone, Carlo; Shoenfeld, Yehuda

    2014-01-01

    We report the case of a 14-year-old girl who developed postural orthostatic tachycardia syndrome (POTS) with chronic fatigue 2 months following Gardasil vaccination. The patient suffered from persistent headaches, dizziness, recurrent syncope, poor motor coordination, weakness, fatigue, myalgias, numbness, tachycardia, dyspnea, visual disturbances, phonophobia, cognitive impairment, insomnia, gastrointestinal disturbances, and a weight loss of 20 pounds. The psychiatric evaluation ruled out the possibility that her symptoms were psychogenic or related to anxiety disorders. Furthermore, the patient tested positive for ANA (1:1280), lupus anticoagulant, and antiphospholipid. On clinical examination she presented livedo reticularis and was diagnosed with Raynaud's syndrome. This case fulfills the criteria for the autoimmune/auto-inflammatory syndrome induced by adjuvants (ASIA). Because human papillomavirus vaccination is universally recommended to teenagers and because POTS frequently results in long-term disabilities (as was the case in our patient), a thorough follow-up of patients who present with relevant complaints after vaccination is strongly recommended.

  14. A Case of Femoral Arteriovenous Fistula Causing High-Output Cardiac Failure, Originally Misdiagnosed as Chronic Fatigue Syndrome

    Directory of Open Access Journals (Sweden)

    J. Porter

    2014-01-01

    Full Text Available Percutaneous arterial catheterisation is commonly undertaken for a range of diagnostic and interventional procedures. Iatrogenic femoral arteriovenous fistulas are an uncommon complication of these procedures. Most are asymptomatic and close spontaneously, but can rarely increase in size leading to the development of symptoms. We report a case of an iatrogenic femoral arteriovenous fistula, causing worsening congestive cardiac failure, in a 34-year-old marathon runner. This was originally diagnosed as chronic fatigue syndrome. Following clinical examination, duplex ultrasound, and CT angiography a significant arteriovenous fistula was confirmed. Elective open surgery was performed, leading to a dramatic and rapid improvement in symptoms. Femoral arteriovenous fistulas have the potential to cause significant haemodynamic effects and can present many years after the initial procedure. Conservative, endovascular, and open surgical management strategies are available.

  15. Big Software for SmallSats: Adapting CFS to CubeSat Missions

    Science.gov (United States)

    Cudmore, Alan P.; Crum, Gary; Sheikh, Salman; Marshall, James

    2015-01-01

    Expanding capabilities and mission objectives for SmallSats and CubeSats is driving the need for reliable, reusable, and robust flight software. While missions are becoming more complicated and the scientific goals more ambitious, the level of acceptable risk has decreased. Design challenges are further compounded by budget and schedule constraints that have not kept pace. NASA's Core Flight Software System (cFS) is an open source solution which enables teams to build flagship satellite level flight software within a CubeSat schedule and budget. NASA originally developed cFS to reduce mission and schedule risk for flagship satellite missions by increasing code reuse and reliability. The Lunar Reconnaissance Orbiter, which launched in 2009, was the first of a growing list of Class B rated missions to use cFS. Large parts of cFS are now open source, which has spurred adoption outside of NASA. This paper reports on the experiences of two teams using cFS for current CubeSat missions. The performance overheads of cFS are quantified, and the reusability of code between missions is discussed. The analysis shows that cFS is well suited to use on CubeSats and demonstrates the portability and modularity of cFS code.

  16. The Core Flight System (cFS) Community: Providing Low Cost Solutions for Small Spacecraft

    Science.gov (United States)

    McComas, David; Wilmot, Jonathan; Cudmore, Alan

    2016-01-01

    In February 2015 the NASA Goddard Space Flight Center (GSFC) completed the open source release of the entire Core Flight Software (cFS) suite. After the open source release a multi-NASA center Configuration Control Board (CCB) was established that has managed multiple cFS product releases. The cFS was developed and is being maintained in compliance with the NASA Class B software development process requirements and the open source release includes all Class B artifacts. The cFS is currently running on three operational science spacecraft and is being used on multiple spacecraft and instrument development efforts. While the cFS itself is a viable flight software (FSW) solution, we have discovered that the cFS community is a continuous source of innovation and growth that provides products and tools that serve the entire FSW lifecycle and future mission needs. This paper summarizes the current state of the cFS community, the key FSW technologies being pursued, the development/verification tools and opportunities for the small satellite community to become engaged. The cFS is a proven high quality and cost-effective solution for small satellites with constrained budgets.

  17. Effects of low-dose clonidine on cardiovascular and autonomic variables in adolescents with chronic fatigue: a randomized controlled trial.

    Science.gov (United States)

    Fagermoen, Even; Sulheim, Dag; Winger, Anette; Andersen, Anders M; Gjerstad, Johannes; Godang, Kristin; Rowe, Peter C; Saul, J Philip; Skovlund, Eva; Wyller, Vegard Bruun

    2015-09-10

    Chronic Fatigue Syndrome (CFS) is a common and disabling condition in adolescence with few treatment options. A central feature of CFS is orthostatic intolerance and abnormal autonomic cardiovascular control characterized by sympathetic predominance. We hypothesized that symptoms as well as the underlying pathophysiology might improve by treatment with the alpha2A-adrenoceptor agonist clonidine. A total of 176 adolescent CFS patients (12-18 years) were assessed for eligibility at a single referral center recruiting nation-wide. Patients were randomized 1:1 by a computer system and started treatment with clonidine capsules (25 μg or 50 μg twice daily, respectively, for body weight below/above 35 kg) or placebo capsules for 9 weeks. Double-blinding was provided. Data were collected from March 2010 until October 2012 as part of The Norwegian Study of Chronic Fatigue Syndrome in Adolescents: Pathophysiology and Intervention Trial (NorCAPITAL). Effect of clonidine intervention was assessed by general linear models in intention-to-treat analyses, including baseline values as covariates in the model. A total of 120 patients (clonidine group n = 60, placebo group n = 60) were enrolled and started treatment. There were 14 drop-outs (5 in the clonidine group, 9 in the placebo group) during the intervention period. At 8 weeks, the clonidine group had lower plasma norepinephrine (difference = 205 pmol/L, p = 0.05) and urine norepinephrine/creatinine ratio (difference = 3.9 nmol/mmol, p = 0.002). During supine rest, the clonidine group had higher heart rate variability in the low-frequency range (LF-HRV, absolute units) (ratio = 1.4, p = 0.007) as well as higher standard deviation of all RR-intervals (SDNN) (difference = 12.0 ms, p = 0.05); during 20° head-up tilt there were no statistical differences in any cardiovascular variable. Symptoms of orthostatic intolerance did not change during the intervention period. Low-dose clonidine reduces catecholamine levels in adolescent

  18. Corrosion fatigue of Inconel 718 and Incoloy 903

    Science.gov (United States)

    Franklin, D. B.; Nelson, E. E.

    1981-01-01

    Corrosion fatigue tests were conducted on Inconel 718 and Incoloy 903 in distilled water, 500 ppm NaCl, and 3.5% NaCl. Results were compared to the endurance limit in air. For Inconel 718, the corrosion fatigue strength (CFS) IN 3.5% NaCl WAS 328 MPa or 75 percent of the endurance limit. For Incoloy 903, the CFS ranged from 234 MPa in distilled water (68 percent of the endurance limit) to 103 MPa in 3.5% NaCl (30 percent of the endurance limit). Results indicate that, for components which have limited fatigue life, an evaluation of the combined effects of fatigue and the corrosive atmosphere must be considered in projecting useful lifetimes.

  19. Are syndromes in environmental medicine variants of somatoform disorders?

    Science.gov (United States)

    Wiesmüller, G A; Ebel, H; Hornberg, C; Kwan, O; Friel, J

    2003-10-01

    To date, relatively little is known about the etiology, pathophysiology, diagnosis, therapy, prevention and prognosis of environment-related syndromes like multiple chemical sensitivity (MCS), idiopathic environmental intolerance (IEI), sick building syndrome (SBS), chronic fatigue syndrome (CFS), candida syndrome (CS) and burnout syndrome (BS). Part of the reason is that these syndromes have not been clearly defined and classified in scientific categories distinct from each other, and that they show clinical similarities to classified somatoform disorders. Furthermore, there are at least three possible explanations for the existence of these syndromes: (1) The syndromes may result from the interaction of environmental factors, individual susceptibility and psychological factors (i.e., how they are perceived and seen by the patient); (2) they may reflect socially and culturally accepted methods of expressing distress; and/or (3) they may be iatrogenic. Despite all the uncertainties in evaluation of environmental syndromes, physicians have the duty to take the affected person's problems seriously. A comprehensive systematic classification which better accounts for these complex clinical manifestations is long overdue. Until these syndromes are well defined, the terms used for them should definitely not be applied to connote a specific disease process.

  20. Patterns of food avoidance in chronic fatigue syndrome: is there a case for dietary recommendations? Patrones de evitación alimenticia en el síndrome de fatiga crónica: ¿hay base para dar recomendaciones dietéticas?

    Directory of Open Access Journals (Sweden)

    J. Trabal

    2012-04-01

    Full Text Available Objectives: To assess the dietary habits and food avoidance-behavior in patients with Chronic Fatigue Syndrome (CFS. Methods: Cross-sectional pilot study with 28 patients diagnosed with severe CFS. Eating habits were assessed with a food frequency questionnaire and 3-day food records. We analyzed variables related to dietary restrictions induced by symptoms or external information. Results: The most prevalent restrictions were for dairy products and gluten-containing grains, with 22 and 15 restricting patients, respectively. Patients reported different digestive symptoms, which did not improve with the use of exclusion diets. Thirteen patients had received information against the intake of certain foods through different sources. Six cases of grains restriction and 11 of dairy were compatible with a counseling-induced pattern of exclusion. Conclusions: There is not a homogeneous pattern of food avoidance. Dietary restrictions should be based on a proven food allergy or intolerance. Dietary counseling should be based on sound nutritional knowledge.Objetivos: Valorar los hábitos dietéticos y la conducta de evitación alimenticia en pacientes con Síndrome de Fatiga Crónica. Métodos: Estudio piloto transversal con 28 pacientes diagnosticados de Síndrome de Fatiga Crónica en grado severo. Los hábitos alimenticios se evaluaron mediante un cuestionario de frecuencia de consumo y registros dietéticos de 3 días. Se analizaron variables relacionadas con las restricciones dietéticas inducidas por síntomas o información externa. Resultados: Las restricciones más frecuentes fueron para los productos lácteos y cereales con gluten, con 22 y 15 pacientes que los restringían, respectivamente. Los pacientes informaron de diferentes síntomas digestivos, que no mejoraron con el uso de dietas de exclusión. Trece pacientes habían recibido información contraria al consumo de ciertos alimentos, a través de diferentes fuentes. Seis casos de

  1. Extreme fatigue and malaise--a syndrome caused by badly cleaned wall-to-wall carpets?

    Science.gov (United States)

    Nexø, E; Skov, P G; Gravesen, S

    1983-01-01

    Complaints connected with the indoor climate are often vague and a cause-effect relationship is difficult to demonstrate. The present paper describes two patients suffering from symptoms in the form of extreme fatigue and malaise. The patients connected their problems to the poorly cleaned working place. We found the working place to be covered with badly cleaned wall-to-wall carpet. Examination of 12 employees showed five to have symptoms related to the working place. Four of the five had precipitating antibodies against extracts of dust collected from the carpets and two of the five had a positive prick test to the same extract. After removal of the carpets all symptoms disappeared. We conclude that vague symptoms related to the indoor climate may be induced by accumulation of organic dust.

  2. Treatment of Guillain-Barré syndrome and causes and treatment of residual fatigue

    NARCIS (Netherlands)

    M.P.J. Garssen (Marcel)

    2005-01-01

    textabstractChapter 1 is the general introduction of this thesis, in which di.erent aspects of the Guillain-Barré syndrome (GBS) are described. GBS is an acute post-infectious polyneuropathy, in which the immune system plays an important role. Insight in pathogenesis, clinical and electrophysiologic

  3. [Epidemiology, diagnostics, and treatment of complications after neuroinfections: chronic fatigue syndrome].

    Science.gov (United States)

    Verner, O M; Murashko, N K

    2012-01-01

    Epidemiology information which testify to prevalence syndrome of chronic ustalostti (SV) is resulted in the article, and from some data this diagnosis is covered at more than 20% patients which carried neyroinfection. SV meets more frequent only in age 40-59, thus for women a disease is marked in 4 times more frequent, than for men. Today etiology of disease remains unknown, but the value of genetic, immunological factors, pathogens, neurogenic violations and features of feed is examined. Possibility of infectious etiology SV causes considerable interest of researchers, but at first this syndrome was examined as a sharp viral infection, where the most reliable exciter is consider the virus of Epshteyna-barr. Using of intravenous introduction of globulin for SV carries experimental character and grounded on a hypothesis about immunological or infectious etiology of this disease.

  4. Comparison of adaptive pacing therapy, cognitive behaviour therapy, graded exercise therapy, and specialist medical care for chronic fatigue syndrome (PACE): a randomised trial.

    Science.gov (United States)

    White, P D; Goldsmith, K A; Johnson, A L; Potts, L; Walwyn, R; DeCesare, J C; Baber, H L; Burgess, M; Clark, L V; Cox, D L; Bavinton, J; Angus, B J; Murphy, G; Murphy, M; O'Dowd, H; Wilks, D; McCrone, P; Chalder, T; Sharpe, M

    2011-03-05

    Trial findings show cognitive behaviour therapy (CBT) and graded exercise therapy (GET) can be effective treatments for chronic fatigue syndrome, but patients' organisations have reported that these treatments can be harmful and favour pacing and specialist health care. We aimed to assess effectiveness and safety of all four treatments. In our parallel-group randomised trial, patients meeting Oxford criteria for chronic fatigue syndrome were recruited from six secondary-care clinics in the UK and randomly allocated by computer-generated sequence to receive specialist medical care (SMC) alone or with adaptive pacing therapy (APT), CBT, or GET. Primary outcomes were fatigue (measured by Chalder fatigue questionnaire score) and physical function (measured by short form-36 subscale score) up to 52 weeks after randomisation, and safety was assessed primarily by recording all serious adverse events, including serious adverse reactions to trial treatments. Primary outcomes were rated by participants, who were necessarily unmasked to treatment assignment; the statistician was masked to treatment assignment for the analysis of primary outcomes. We used longitudinal regression models to compare SMC alone with other treatments, APT with CBT, and APT with GET. The final analysis included all participants for whom we had data for primary outcomes. This trial is registered at http://isrctn.org, number ISRCTN54285094. We recruited 641 eligible patients, of whom 160 were assigned to the APT group, 161 to the CBT group, 160 to the GET group, and 160 to the SMC-alone group. Compared with SMC alone, mean fatigue scores at 52 weeks were 3·4 (95% CI 1·8 to 5·0) points lower for CBT (p = 0·0001) and 3·2 (1·7 to 4·8) points lower for GET (p = 0·0003), but did not differ for APT (0·7 [-0·9 to 2·3] points lower; p = 0·38). Compared with SMC alone, mean physical function scores were 7·1 (2·0 to 12·1) points higher for CBT (p = 0·0068) and 9·4 (4·4 to 14·4) points higher

  5. Postural Orthostatic Tachycardia With Chronic Fatigue After HPV Vaccination as Part of the “Autoimmune/Auto-inflammatory Syndrome Induced by Adjuvants”

    Directory of Open Access Journals (Sweden)

    Lucija Tomljenovic PhD

    2014-03-01

    Full Text Available We report the case of a 14-year-old girl who developed postural orthostatic tachycardia syndrome (POTS with chronic fatigue 2 months following Gardasil vaccination. The patient suffered from persistent headaches, dizziness, recurrent syncope, poor motor coordination, weakness, fatigue, myalgias, numbness, tachycardia, dyspnea, visual disturbances, phonophobia, cognitive impairment, insomnia, gastrointestinal disturbances, and a weight loss of 20 pounds. The psychiatric evaluation ruled out the possibility that her symptoms were psychogenic or related to anxiety disorders. Furthermore, the patient tested positive for ANA (1:1280, lupus anticoagulant, and antiphospholipid. On clinical examination she presented livedo reticularis and was diagnosed with Raynaud’s syndrome. This case fulfills the criteria for the autoimmune/auto-inflammatory syndrome induced by adjuvants (ASIA. Because human papillomavirus vaccination is universally recommended to teenagers and because POTS frequently results in long-term disabilities (as was the case in our patient, a thorough follow-up of patients who present with relevant complaints after vaccination is strongly recommended.

  6. Big Software for SmallSats: Adapting cFS to CubeSat Missions

    Science.gov (United States)

    Cudmore, Alan P.; Crum, Gary Alex; Sheikh, Salman; Marshall, James

    2015-01-01

    Expanding capabilities and mission objectives for SmallSats and CubeSats is driving the need for reliable, reusable, and robust flight software. While missions are becoming more complicated and the scientific goals more ambitious, the level of acceptable risk has decreased. Design challenges are further compounded by budget and schedule constraints that have not kept pace. NASA's Core Flight Software System (cFS) is an open source solution which enables teams to build flagship satellite level flight software within a CubeSat schedule and budget. NASA originally developed cFS to reduce mission and schedule risk for flagship satellite missions by increasing code reuse and reliability. The Lunar Reconnaissance Orbiter, which launched in 2009, was the first of a growing list of Class B rated missions to use cFS.

  7. Climateric: fatigue or third stage of the general adaptation syndrome Climaterio: fatiga o tercera etapa del síndrome de adaptación general

    OpenAIRE

    William Alvarez Gaviria

    2004-01-01

    The origin of climacteric has been subject of debate. Most opinions agree in that it arises exclusively from natural selection. In this paper the author argues that, besides this reason there is another, even more important; for him, climacteric is the final response to fatigue or the third stage of the general adaptation syndrome, just as in elderly people there is a loss of the capacity of proliferation of fibroblasts and lack of response to insulin. From a genetic point of view, this corre...

  8. Fatigue and depression predict physician visits and work disability in women with primary Sjögren's syndrome: results from a cohort study.

    Science.gov (United States)

    Westhoff, Gisela; Dörner, Thomas; Zink, Angela

    2012-02-01

    Patients with primary SS (pSS) are frequently suffering from multiple enduring disorders that raise the risk of work disability and require treatment by various health-care specialists. We aimed at determining predictors of physician visits and work disability in pSS patients. Physician visits within the past 6 months, employment status and sick leave were compared among 176 female pSS patients and 115 age-matched controls. Dryness, pain, fatigue and depression were assessed by rating scales of the EULAR Sjögren's Syndrome Patient Reported Index (ESSPRI), the Profile of Fatigue and Discomfort (PROFAD) and Patient Health Questionnaire depression measurements (PHQ-9). Factors associated with an increased number of physician visits and inability to work were determined by multivariate logistic regression analysis. Patients and controls were comparable in age and education, but differed significantly in the prevalence of depression (38.1 vs 7.9%, P high ratings for the statement 'I have had difficulties to keep going, was easily worn out or lacking in energy' had a highly increased risk of not being gainfully employed (adjusted OR 4.1; 95% CI 1.5, 11.2; P < 0.001). In pSS, lack of stamina and/or depression cause a higher level of individual and societal burden than dry eyes and mouth. Fatigue and depression deserve more recognition as treatment targets in pSS.

  9. 理虚解郁方对慢性疲劳综合征患者负性情绪及皮质醇与5-羟色胺的影响%Effect of “Lixu Jieyu Recipe” on Negative Emotion, 5-HT and Cortisol of Patients with Chronic Fatigue Syndrome

    Institute of Scientific and Technical Information of China (English)

    张振贤; 张烨; 王扬; 陈敏; 吴丽丽; 王晓静; 沈箭箫

    2012-01-01

    Objective: To explore the effect of "Lixu Jieyu Recipe" on mental symptoms,cortisol and 5-HT of patients with chronic fatigue syndrome (CFS). Methods: Sixty-six patients with CFS were randomly divided into treatment group and control group with 33 cases in each group. The treatment group was treated with "Lixu Jieyu Recipe" and the control group was treated with multivitamin tablet,ATP and oryzanol,with a course of 12 weeks. The negative emotion of patients was evaluated by SCL-90 and FAI scales,and the levels of 5-HT and cortisol were tested. Results: (1)The total effective rates of treatment group and control group were 90. 91% and 69. 70% respectively evaluated by FAI scale,and there was a statistical difference between the two groups (P <0.05). (2)After treatment,the scores of all the factors of SCL-90 scale remarkably decreased in treatment group {P <0. 05) ,while in addition to the coercion and anxiety,the scores of the rest factors of SCL-90 scale significantly decreased in control group {P <0.05) ,and the scores of somatization,hostility,coercion,depression and anxiety and the total score in treatment group were lower than those in control group (P<0.05,P<0.01). (3) After treatment,the level of cortisol decreased (P <0. 05) and the level of 5-HT increased ( P <0. 05) in treatment group,and there was a statistical difference on the levels of cortisol and 5-HT between the two groups. Conclusion: "Lixu Jieyu Recipe" can relieve the mental and physical symptoms of patients with CFS and promote the recovery of the fatigue state by adjusting the levels of cortisol and 5-HT.%目的:探讨理虚解郁方对慢性疲劳综合征(CFS)患者精神情志症状及皮质醇、5-羟色胺(5-HT)水平的影响.方法:将66例CFS患者随机分为治疗组和对照组,每组33例.治疗组给予理虚解郁方加减治疗,对照组给予维康福、三磷酸腺苷、谷维素治疗,疗程均为12周.采用心理学症状自评量表( SCL-90)和疲劳评定量表( FAI)评

  10. Assessment of fatigue and dryness in primary Sjögren's syndrome: Brazilian version of "Profile of Fatigue and Discomfort - Sicca Symptoms Inventory (short form) (PROFAD-SSI-SF)".

    Science.gov (United States)

    Miyamoto, Samira Tatiyama; Paganotti, Maurício Aquino; Serrano, Érica Vieira; Giovelli, Raquel Altoé; Valim, Valéria

    2015-01-01

    To perform a cross-cultural adaptation and validation of the Profile of Fatigue and Discomfort - Sicca Symptoms Inventory (short form) (PROFAD-SSI-SF) questionnaire assessing the subjective aspects of the symptoms of primary Sjögren syndrome (pSS), for the Brazilian Portuguese language. Conceptual, of the item, semantic and operational equivalences were evaluated. The Brazilian version of PROFAD-SSI-SF was administered to 62 women with pSS according to the European-American consensus 2002 to assess measurement equivalence. α-Cronbach was used for internal consistency; intraclass correlation coefficient (ICC) for intraobserver reproducibility; and Spearman correlation coefficient for validity by comparing with Patient Global Assessment (PaGA), EULAR Sjögren's Syndrome Patient Reported Index (ESSPRI), Functional Assessment of Chronic Illness Therapy Fatigue Subscale (FACIT-F) and EuroQOL (EQ-5D). The internal consistency of PROFAD, SSI and total score was 0.80; 0.78; and 0.87, respectively. The intraobserver reproducibility of total PROFAD was 0.89; of total SSI of 0.86; and total score of 0.89. In terms of validity, PROFAD correlated significantly with PaGA (r = 0.50), FACIT-F (r = 0.59), ESSPRI (r = 0.58) and all domains of EQ-5D, with the exception of Mobility. On the other hand, SSI correlated significantly with PaGA (r = 0.43), FACIT-F (r = 0.57), ESSPRI (r = 0.55) and most areas of EQ-5D. The total score of PROFAD-SSI-SF had a non-statistically significant correlation only with Mobility domain and with 1-100 range of EQ-5D. The Portuguese version of PROFAD-SSI-SF proved to be an adaptable, reproducible and valid tool for the Brazilian Portuguese language. Copyright © 2014 Elsevier Editora Ltda. All rights reserved.

  11. Core Flight System (cFS) a Low Cost Solution for SmallSats

    Science.gov (United States)

    McComas, David; Strege, Susanne; Wilmot, Jonathan

    2015-01-01

    The cFS is a FSW product line that uses a layered architecture and compile-time configuration parameters which make it portable and scalable for a wide range of platforms. The software layers that defined the application run-time environment are now under a NASA-wide configuration control board with the goal of sustaining an open-source application ecosystem.

  12. Postulated vasoactive neuropeptide immunopathology affecting the blood–brain/blood–spinal barrier in certain neuropsychiatric fatigue-related conditions: A role for phosphodiesterase inhibitors in treatment?

    Directory of Open Access Journals (Sweden)

    Sonya Marshall-Gradisnik

    2008-10-01

    Full Text Available Donald R Staines1,2, Ekua W Brenu2, Sonya Marshall-Gradisnik21Queensland Health, Gold Coast Population Health Unit, Southport, Gold Coast, Queensland, Australia; 2Faculty of Health Science and Medicine, Population Health and Neuroimmunology Unit, Bond University, Robina, Queensland, AustraliaAbstract: Neuropsychiatric symptoms occur in a number of neurological fatigue-related conditions including multiple sclerosis (MS, Parkinson’s disease (PD, amyotrophic lateral sclerosis (ALS, and chronic fatigue syndrome (CFS. These conditions have been attributed variably to neuroinflammatory and neurodegenerative processes. While autoimmune pathology, at least in part, has long been suspected in these conditions proof has been elusive. Autoimmune pathomechanisms affecting the blood–brain barrier (BBB or blood–spinal barrier (BSB may predispose the BBB/BSB to ‘leakiness’ and be a precursor to additional autoimmune events resulting in neuroinflammatory or neurodegenerative processes. The aim of the paper is to postulate immunopathology of the cerebrospinal perivascular compartment involving certain vasoactive neuropeptides, specifically pituitary adenylate cyclase-activating polypeptide (PACAP and vasoactive intestinal peptide (VIP, in the etiology of certain neuropsychiatric fatigue-related conditions such as MS, ALS, PD, and CFS. Vasoactive neuropeptides (VNs such as PACAP and VIP have critical roles as neurotransmitters, vasodilators including perfusion and hypoxia regulators, and immune and nociception modulators. PACAP and VIP are widely distributed in the central nervous system (CNS and have key roles in CNS blood vessels including maintaining functional integrity of the BBB and BSB. Autoimmunity affecting these VNs would likely have a detrimental effect on BBB and BSB functioning arguably predisposing to further pathological processes. Virchow–Robin spaces (VRS are perivascular compartments surrounding small vessels within the CNS which

  13. Causes for Chronic Fatigue Syndrome among Office Workers and Countermeasures%办公室工作人员慢性疲劳综合征的成因与应对策略

    Institute of Scientific and Technical Information of China (English)

    郑培萍

    2015-01-01

    随着现代生活工作节奏的加快,办公室工作人员的慢性疲劳综合征明显,成为影响办公室工作人员身心健康的重要原因。慢性疲劳综合征表现为头痛、肌肉酸痛、精神不振等征状,其长期的存在既影响了健康,又影响了工作的效率。因此,加大对办公室工作人员慢性疲劳综合征的研究与预防,有着重要的意义。本文结合办公室工作人员慢性疲劳综合征的危害,提出了应对的策略。以期为办公室工作人员的健康水平的提升,提供有益的参考。%With the speeding up of pace of modern life,the obviously widespread chronic fatigue syndrome among office workers has become a major factor affecting their physical and mental health.Chronic fatigue syndrome is characterized as syndromes such as headache,muscle pain and lassitude.Long term chronic fatigue syndrome affects not only health but also work efficiency.Therefore,it is of significance to strengthen the research and prevention of chronic fatigue syndrome among office workers.Combining the harm of chronic fatigue syndrome to office workers,the paper puts forward corresponding measures with the hope to provide useful reference for improving health of office workers.

  14. Chronic Fatigue Syndrome

    Science.gov (United States)

    ... or more of the following symptoms: difficulty with short-term memory or concentration sore throat tender lymph nodes (glands) ... symptoms affect a person's overall mental health, including memory, personality, ... small activities and slowly working up to a higher level of exercise) is ...

  15. cFE/CFS (Core Flight Executive/Core Flight System)

    Science.gov (United States)

    Wildermann, Charles P.

    2008-01-01

    This viewgraph presentation describes in detail the requirements and goals of the Core Flight Executive (cFE) and the Core Flight System (CFS). The Core Flight Software System is a mission independent, platform-independent, Flight Software (FSW) environment integrating a reusable core flight executive (cFE). The CFS goals include: 1) Reduce time to deploy high quality flight software; 2) Reduce project schedule and cost uncertainty; 3) Directly facilitate formalized software reuse; 4) Enable collaboration across organizations; 5) Simplify sustaining engineering (AKA. FSW maintenance); 6) Scale from small instruments to System of Systems; 7) Platform for advanced concepts and prototyping; and 7) Common standards and tools across the branch and NASA wide.

  16. Relevance research on university students’ mental fatigue and TCM syndrome%大学生心理疲劳与中医体质相关性研究

    Institute of Scientific and Technical Information of China (English)

    岳健; 张娇; 马捷; 吴凤芝; 张炜悦; 李峰

    2016-01-01

    Objective To investigate and analyze TCM syndrome characteristics, impact factors and internal relationship among the factors of mental fatigue of university students. A preliminary understanding of mental fatigue situation of university students and prevent diseases was acquired in advance. Methods 100 students were randomly selected in Beijing University of Chinese Medicine, of whom 40 were undergraduate students and 60 were post-graduate students. Mental fatigue questionnaire was used to investigate mental fatigue situation for students, and TCM constitution scale was applied to collect TCM syndromes. A body energy survey was also conducted. Results In undergraduate and post-graduate students, the mental fatigue rate was relatively higher, both of them were over 50%of the total numbers, 57.5%(23/40)、61.7%(37/60) respectively. For the fatigue levels distribution in these two groups, the ratios of slight mental fatigue (undergraduate:52.5%;post-graduate:56.67%) were both higher than those of severe mental fatigue (undergraduate:5%;post-graduate:5%). In the undergraduate group, the top three biased constitutions among mental fatigue students were yang deficiency (7 out of 23:30.43%), qi deficiency (3 out of 23:13.04%) and dampness-heat (3 out of 23:13.04%). In the post-graduate group, the top three biased constitutions were yang deficiency (11 out of 37:29.73%), qi deficiency (6 out of 37: 16.22%) and dampness-heat (5 out of 37: 13.51%). Conclusion It is easier for university students with biased constitution to suffer from mental fatigue, mostly with yang deficiency, qi deficiency and dampness-heat constitution.%目的:调查分析当代大学生心理疲劳的中医体质特点及其影响因素,以及各因素的内在关系,初步了解大学生的心理疲劳状况,及早预防疾病。方法随机抽取北京中医药大学在校大学生100人,其中本科生40人,研究生60人。采用心理疲劳调查问卷调查大学生心理疲劳状况

  17. Incompressible Modes Excited by Supersonic Shear in Boundary Layers: Acoustic CFS Instability

    Science.gov (United States)

    Belyaev, Mikhail A.

    2017-02-01

    We present an instability for exciting incompressible modes (e.g., gravity or Rossby modes) at the surface of a star accreting through a boundary layer. The instability excites a stellar mode by sourcing an acoustic wave in the disk at the boundary layer, which carries a flux of energy and angular momentum with the opposite sign as the energy and angular momentum density of the stellar mode. We call this instability the acoustic Chandrasekhar–Friedman–Schutz (CFS) instability, because of the direct analogy to the CFS instability for exciting modes on a rotating star by emission of energy in the form of gravitational waves. However, the acoustic CFS instability differs from its gravitational wave counterpart in that the fluid medium in which the acoustic wave propagates (i.e., the accretion disk) typically rotates faster than the star in which the incompressible mode is sourced. For this reason, the instability can operate even for a non-rotating star in the presence of an accretion disk. We discuss applications of our results to high-frequency quasi-periodic oscillations in accreting black hole and neutron star systems and dwarf nova oscillations in cataclysmic variables.

  18. Treatment Guidelines for Rheumatologic Manifestations of Sjögren's Syndrome: Use of Biologic Agents, Management of Fatigue, and Inflammatory Musculoskeletal Pain.

    Science.gov (United States)

    Carsons, Steven E; Vivino, Frederick B; Parke, Ann; Carteron, Nancy; Sankar, Vidya; Brasington, Richard; Brennan, Michael T; Ehlers, William; Fox, Robert; Scofield, Hal; Hammitt, Katherine M; Birnbaum, Julius; Kassan, Stuart; Mandel, Steven

    2017-04-01

    The Sjögren's Syndrome Foundation clinical practice guidelines (CPGs) are designed to improve quality and consistency of care in Sjögren's syndrome by offering recommendations for management. Management questions for the systemic manifestations of Sjögren's syndrome were posed by the CPG committee with input from patients and rheumatologists. Clinical questions were assigned to a topic review group that performed systematic reviews and data extraction and drafted guidelines. Quality of evidence and strength of recommendation were rated using the American Society of Clinical Oncology's modification of the Grading of Recommendations Assessment, Development, and Evaluation. Guideline recommendations were reviewed by a consensus expert panel (CEP) composed of 30-40 clinicians from academia and community practices, as well as registered nurses and patients, using a modified Delphi process. A CEP agreement level of 75% was set as a minimum for adoption of a guideline recommendation. Consensus was achieved for 19 recommendations; for 11 additional modules, available data were insufficient to allow a recommendation to be formulated. Of the 19 recommendations, 15 required 1 Delphi round, 2 required 2 rounds, and 2 required 3 rounds. Key recommendations include a decision tree for the use of oral disease-modifying antirheumatic drugs for inflammatory musculoskeletal pain, use of self-care measures and advice regarding exercise to reduce fatigue, and the use of rituximab in selected clinical settings for oral and ocular dryness and for certain extraglandular manifestations, including vasculitis, severe parotid swelling, inflammatory arthritis, pulmonary disease, and mononeuritis multiplex. The CPG committee strongly discouraged the use of tumor necrosis factor inhibitors for sicca symptoms and for the majority of clinical contexts in primary Sjögren's syndrome. © 2016, American College of Rheumatology.

  19. Reliable multi-label learning via conformal predictor and random forest for syndrome differentiation of chronic fatigue in traditional Chinese medicine.

    Directory of Open Access Journals (Sweden)

    Huazhen Wang

    Full Text Available OBJECTIVE: Chronic Fatigue (CF still remains unclear about its etiology, pathophysiology, nomenclature and diagnostic criteria in the medical community. Traditional Chinese medicine (TCM adopts a unique diagnostic method, namely 'bian zheng lun zhi' or syndrome differentiation, to diagnose the CF with a set of syndrome factors, which can be regarded as the Multi-Label Learning (MLL problem in the machine learning literature. To obtain an effective and reliable diagnostic tool, we use Conformal Predictor (CP, Random Forest (RF and Problem Transformation method (PT for the syndrome differentiation of CF. METHODS AND MATERIALS: In this work, using PT method, CP-RF is extended to handle MLL problem. CP-RF applies RF to measure the confidence level (p-value of each label being the true label, and then selects multiple labels whose p-values are larger than the pre-defined significance level as the region prediction. In this paper, we compare the proposed CP-RF with typical CP-NBC(Naïve Bayes Classifier, CP-KNN(K-Nearest Neighbors and ML-KNN on CF dataset, which consists of 736 cases. Specifically, 95 symptoms are used to identify CF, and four syndrome factors are employed in the syndrome differentiation, including 'spleen deficiency', 'heart deficiency', 'liver stagnation' and 'qi deficiency'. THE RESULTS: CP-RF demonstrates an outstanding performance beyond CP-NBC, CP-KNN and ML-KNN under the general metrics of subset accuracy, hamming loss, one-error, coverage, ranking loss and average precision. Furthermore, the performance of CP-RF remains steady at the large scale of confidence levels from 80% to 100%, which indicates its robustness to the threshold determination. In addition, the confidence evaluation provided by CP is valid and well-calibrated. CONCLUSION: CP-RF not only offers outstanding performance but also provides valid confidence evaluation for the CF syndrome differentiation. It would be well applicable to TCM practitioners and

  20. Improving Health and Quality of Life

    Science.gov (United States)

    ... Fatigue Syndrome (CFS) Share Compartir Improving Health and Quality of Life On this Page Cognitive Behavioral Therapy (CBT) Support ... and improve their ability to function and their quality of life. Doctors may refer some of their CFS patients ...

  1. Recalibration of CFS seasonal precipitation forecasts using statistical techniques for bias correction

    Science.gov (United States)

    Bliefernicht, Jan; Laux, Patrick; Siegmund, Jonatan; Kunstmann, Harald

    2013-04-01

    The development and application of statistical techniques with a special focus on a recalibration of meteorological or hydrological forecasts to eliminate the bias between forecasts and observations has received a great deal of attention in recent years. One reason is that retrospective forecasts are nowadays available which allows for a proper training and validation of this kind of techniques. The objective of this presentation is to propose several statistical techniques with different degree of complexity and to evaluate and compare their performance for a recalibration of seasonal ensemble forecasts of monthly precipitation. The techniques selected in this study range from straightforward normal score and quantile-quantile transformation, local scaling, to more sophisticated and novel statistical techniques such as Copula-based methodology recently proposed by Laux et al. (2011). The seasonal forecasts are derived from the Climate Forecast System Version 2. This version is the current coupled ocean-atmosphere general circulation model of the U.S. National Centers for Environmental Prediction used to provide forecasts up to nine months. The CFS precipitation forecasts are compared to monthly precipitation observations from the Global Precipitation Climatology Centre. The statistical techniques are tested for semi-arid regions in West Africa and the Indian subcontinent focusing on large-scale river basins such as the Ganges and the Volta basin. In both regions seasonal precipitation forecasts are a crucial source of information for the prediction of hydro-meteorological extremes, in particular for droughts. The evaluation is done using retrospective CFS ensemble forecast from 1982 to 2009. The training of the statistical techniques is done in a cross-validation mode. The outcome of this investigation illustrates large systematic differences between forecasts and observations, in particular for the Volta basin in West Africa. The selection of straightforward

  2. 肝郁脾虚型疲劳性亚健康者疲劳状况、体质体能状态及两者相关性研究%Correlation between Fatigue and Basic Physical Fitness of Sub-health State of Fatigue Type and TCM Syndrome Pattern of Liver-qi Stagnation and Spleen-qi Deficiency

    Institute of Scientific and Technical Information of China (English)

    张雅静; 汤宇; 李真; 王文萍; 薛晓琳; 王天芳; 李冠儒; 王佳佳; 韩萍; 钟燕宇; 李力; 王庆波

    2011-01-01

    目的:探讨肝郁脾虚型疲劳性亚健康人群疲劳状况和体质体能间的相关性.方法:采用主观指标疲劳评定量表FSAS及客观指标GMCS-2型体质检测仪等,分别对符合纳入标准的200例肝郁脾虚型疲劳性亚健康人群的疲劳类型程度及特征、基本体质体能及认知功能(简单反应时)状况进行测评.结果:疲劳性亚健康肝郁脾虚型受试者的FSAS中躯体疲劳分别与体重、简单反应时呈显著正相关;精神疫劳、疲劳后果和疲劳程度总分分别与肺活量、台阶指数呈显著负相关;疲劳对睡眠休息的反应、疲劳的情境性分别与肺活量呈显著负相关;各因子均与简单反应时呈显著正相关.结论:疲劳性亚健康肝郁脾虚型人群的疲劳状况和体质体能间有较为显著的相关性.%Objective: To explore the correlation between the fatigue and the basic physical fitness in cases with sub-health of fatigue type and the TCM syndrome pattern of liver-qi stagnation and spleen-qi deficiency. Methods: 200 cases with sub-health of fatigue type and the TCM syndrome pattern of liver-qi stagnation and spleen-qi deficiency were chose from the three hospitals in Beijing, Henan and Liaoning,and their fatigue and the basic physical fitness and cognitive function were measured with Fatigue Selfassessment Scale ( FSAS ) and GMCS-2 type physical detector separately. Results: The factors of FSAS were positive correlation to height and weight and cognitive function; the mental fatigue, the consequences of fatigue and the fatigue scores were significantly negative correlation to vital capacity and the step test; the fatigue response after sleep / rest and the situations sensitive were significantly negative correlation to vital capacity; all factors were significantly positive correlation to cognitive function. Conclusion: The fatigue state in cases with sub-health of fatigue type and the TCM syndrome pattern of liver-qi stagnation and spleen

  3. Incompressible Modes Excited by Supersonic Shear in Boundary Layers: Acoustic CFS Instability

    CERN Document Server

    Belyaev, Mikhail

    2016-01-01

    We present an instability for exciting incompressible modes (e.g. gravity or Rossby modes) at the surface of a star accreting through a boundary layer. The instability excites a stellar mode by sourcing an acoustic wave in the disk at the boundary layer, which carries a flux of energy and angular momentum with the opposite sign as the energy and angular momentum density of the stellar mode. We call this instability the acoustic CFS instability, because of the direct analogy to the Chandrasekhar-Friedman-Schutz instability for exciting modes on a rotating star by emission of energy in the form of gravitational waves. However, the acoustic CFS instability differs from its gravitational wave counterpart in that the fluid medium in which the acoustic wave propagates (i.e.\\ the accretion disk) typically rotates faster than the star in which the incompressible mode is sourced. For this reason, the instability can operate even for a non-rotating star in the presence of an accretion disk. We discuss applications of o...

  4. A randomised trial of adaptive pacing therapy, cognitive behaviour therapy, graded exercise, and specialist medical care for chronic fatigue syndrome (PACE): statistical analysis plan

    Science.gov (United States)

    2013-01-01

    Background The publication of protocols by medical journals is increasingly becoming an accepted means for promoting good quality research and maximising transparency. Recently, Finfer and Bellomo have suggested the publication of statistical analysis plans (SAPs).The aim of this paper is to make public and to report in detail the planned analyses that were approved by the Trial Steering Committee in May 2010 for the principal papers of the PACE (Pacing, graded Activity, and Cognitive behaviour therapy: a randomised Evaluation) trial, a treatment trial for chronic fatigue syndrome. It illustrates planned analyses of a complex intervention trial that allows for the impact of clustering by care providers, where multiple care-providers are present for each patient in some but not all arms of the trial. Results The trial design, objectives and data collection are reported. Considerations relating to blinding, samples, adherence to the protocol, stratification, centre and other clustering effects, missing data, multiplicity and compliance are described. Descriptive, interim and final analyses of the primary and secondary outcomes are then outlined. Conclusions This SAP maximises transparency, providing a record of all planned analyses, and it may be a resource for those who are developing SAPs, acting as an illustrative example for teaching and methodological research. It is not the sum of the statistical analysis sections of the principal papers, being completed well before individual papers were drafted. Trial registration ISRCTN54285094 assigned 22 May 2003; First participant was randomised on 18 March 2005. PMID:24225069

  5. A randomised trial of adaptive pacing therapy, cognitive behaviour therapy, graded exercise, and specialist medical care for chronic fatigue syndrome (PACE): statistical analysis plan.

    Science.gov (United States)

    Walwyn, Rebecca; Potts, Laura; McCrone, Paul; Johnson, Anthony L; DeCesare, Julia C; Baber, Hannah; Goldsmith, Kimberley; Sharpe, Michael; Chalder, Trudie; White, Peter D

    2013-11-13

    The publication of protocols by medical journals is increasingly becoming an accepted means for promoting good quality research and maximising transparency. Recently, Finfer and Bellomo have suggested the publication of statistical analysis plans (SAPs).The aim of this paper is to make public and to report in detail the planned analyses that were approved by the Trial Steering Committee in May 2010 for the principal papers of the PACE (Pacing, graded Activity, and Cognitive behaviour therapy: a randomised Evaluation) trial, a treatment trial for chronic fatigue syndrome. It illustrates planned analyses of a complex intervention trial that allows for the impact of clustering by care providers, where multiple care-providers are present for each patient in some but not all arms of the trial. The trial design, objectives and data collection are reported. Considerations relating to blinding, samples, adherence to the protocol, stratification, centre and other clustering effects, missing data, multiplicity and compliance are described. Descriptive, interim and final analyses of the primary and secondary outcomes are then outlined. This SAP maximises transparency, providing a record of all planned analyses, and it may be a resource for those who are developing SAPs, acting as an illustrative example for teaching and methodological research. It is not the sum of the statistical analysis sections of the principal papers, being completed well before individual papers were drafted. ISRCTN54285094 assigned 22 May 2003; First participant was randomised on 18 March 2005.

  6. RELATIONSHIP BETWEEN FATIGUE AND MENTAL HEALTH IN NAVY FLIGHT PERSONNEL%海军飞行人员疲劳状况与心理健康的关系

    Institute of Scientific and Technical Information of China (English)

    熊波; 孙国栋; 陈晶晶; 柳甜甜

    2012-01-01

    Objective To study the condition of fatigue and its relationship with mental health in flight personnel, thus to provide the basis for mental intervention and working out training scheme. Methods A total of 540 navy flight personnel were evaluated by Fatigue Assessment Instrument (FAI) and Symptom Checklist 90(SCL-90) . The data were analyzed with SPSS 15.0. Results The severity of fatigue in flight personnel was not significantly different from healthy group,but was significantly lower than in chronic fatigue syndrome(CFS) group (P<0. 01). The condition of fatigue in fighter-bomber personnel was higher than in fighter ones (P<0. 01), the situation-specificity in bomber personnel was higher than in transport ones(P<0.05) ;The situation-specificity in mechanics was lower than other professionals (pilots, navigators, correspondents )(P<0.01) .The condition of fatigue was significantly correlated with mental health in flight personnel. Multiple correlation regression analysis showed that somatization and obsessive-compulsive disorder in SCL-90 were the main factors inducing fatigue in flight personnel. Conclusion The severity of fatigue in flight personnel of different fighting planes and professions was different. The conditions of fatigue was closely correlated with mental health in flight personnel.%目的 探讨海军飞行人员疲劳状况及其与心理健康的相关性,为疗养期间开展综合心理干预及制订训练方案提供依据.方法 采用疲劳评定量表(FAI)和症状自评量表(SCL-90)对540名海军飞行人员进行量表测评,数据采用SPSS 15.0软件包进行统计分析.结果 飞行人员在疲劳的严重程度上与健康组无明显差异,而明显低于慢性疲劳综合征(CFS)病人组(P<0.01);不同机种飞行人员在疲劳的严重程度和情境特异性方面存在显著性差异(P<0.05,P<0.01),其中轰炸机飞行人员的疲劳程度显著高于歼击机飞行人员,情境特异性显著高于运输机飞

  7. Fatigue (PDQ)

    Science.gov (United States)

    ... of daily living . Better quality of life . More satisfaction with life. A greater sense of well-being. ... and decrease fatigue. The importance of eating enough food and drinking enough fluids. Physical therapy for patients ...

  8. 视疲劳患者症状调查及证型分布分析%Analysis of Visual Fatigue in Patients with Symptoms and Syndrome Type

    Institute of Scientific and Technical Information of China (English)

    曾洁萍; 王满华; 黄映红; 颜家渝

    2015-01-01

    Objective To explore the law of TCM syndrome dif erentiation of asthenopia and its related factors in modern life through surveys of symptoms and signs of asthenopia . Methods We designed clinical questionnaires to col ect the general information and four diagnostic methods information, and gave them some related examinations such as visual acuity, optometry, intraocular pressure measurment, recessive strabismus measurement, convergence, corneal epithelium fluorescein staining and etc. We put the data of quantified TCM symptom-sign (including the symptoms of tongue and pulse) into computer to establish the database. SPSS17.0 statistics software was adopted to analyse thefrequencies of syndromesand TCM syndromes . Results ①The most common symptoms in descending order were dry eyes, eye fatigue, orbit acid bilges, eye pain, hypopsia, blur ed vision, sourness of eye, neck shoulder ache, lassitude (frequency>50%). ②The cumulative frequence of TCM syndromes including yin deficiency of liver and kidney, liver-kidney yin deficiency with qi stagnation, liver-kidney yin deficiency with dampness.was 81.08%. The frequence of syndrome of yin deficiency of liver and kidney was 43.24%. Conclusion ①Local eye symptoms were the main manifestations of asthenopia, accompanied with whole body symptomsand cor elated with psychogenic factors.②TCM syndrome types of asthenopia were categorized .③which were liver-kidney yin deficiency, liver-kidney yin deficiency with qi stagnation, and liver-kidney yin deficiency with dampness. Among them, liver-kidney yin deficiency was the most common type, some syndrome types were compounded with each other.%目的:通过对视疲劳患者的调查,探讨视疲劳患者的症状发生频率及证型分布。方法设计视疲劳调查表,采集视疲劳患者一般资料及中医四诊信息,进行视力、验光、隐斜、眼压、角膜上皮荧光素染色等检查,将患者各症状、体征、舌脉录入计算机

  9. [Auditory fatigue].

    Science.gov (United States)

    Sanjuán Juaristi, Julio; Sanjuán Martínez-Conde, Mar

    2015-01-01

    Given the relevance of possible hearing losses due to sound overloads and the short list of references of objective procedures for their study, we provide a technique that gives precise data about the audiometric profile and recruitment factor. Our objectives were to determine peripheral fatigue, through the cochlear microphonic response to sound pressure overload stimuli, as well as to measure recovery time, establishing parameters for differentiation with regard to current psychoacoustic and clinical studies. We used specific instruments for the study of cochlear microphonic response, plus a function generator that provided us with stimuli of different intensities and harmonic components. In Wistar rats, we first measured the normal microphonic response and then the effect of auditory fatigue on it. Using a 60dB pure tone acoustic stimulation, we obtained a microphonic response at 20dB. We then caused fatigue with 100dB of the same frequency, reaching a loss of approximately 11dB after 15minutes; after that, the deterioration slowed and did not exceed 15dB. By means of complex random tone maskers or white noise, no fatigue was caused to the sensory receptors, not even at levels of 100dB and over an hour of overstimulation. No fatigue was observed in terms of sensory receptors. Deterioration of peripheral perception through intense overstimulation may be due to biochemical changes of desensitisation due to exhaustion. Auditory fatigue in subjective clinical trials presumably affects supracochlear sections. The auditory fatigue tests found are not in line with those obtained subjectively in clinical and psychoacoustic trials. Copyright © 2013 Elsevier España, S.L.U. y Sociedad Española de Otorrinolaringología y Patología Cérvico-Facial. All rights reserved.

  10. Research progress of exercise-induced fatigue

    Directory of Open Access Journals (Sweden)

    Peng-yi DAI

    2016-12-01

    Full Text Available Exercise-induced fatigue is a comprehensive response to a variety of physiological and biochemical changes in the body, and can affect people's quality of life to different extents. If no timely recovery after occurrence of fatigue, accumulated gradually, it can lead to "burnout", a "overtraining syndrome", "chronic fatigue syndrome", etc., which will cause endocrine disturbance, immune suppression, even physical illness. Exercise-induced fatigue becomes an important factor endangering human health. In recent years, many experts and scholars at home and abroad are committed to the research of exercise-induced fatigue, and have put forward a variety of hypothesis to explain the cause of exercise-induced fatigue. They expect to find out the methods for preventing and eliminating exercise-induced fatigue. This article discusses mainly the pathogenesis, model building, elimination/ relief, etc. of exercise-induced fatigue to point out the research achievements of exercise-induced fatigue and its existing problems. DOI: 10.11855/j.issn.0577-7402.2016.11.14

  11. Fibromyalgia syndrome pathology and environmental influences on afflictions with medically unexplained symptoms.

    Science.gov (United States)

    Albrecht, Phillip J; Rice, Frank L

    2016-06-01

    Fibromyalgia syndrome (FMS) is a clinical disorder predominant in females with unknown etiology and medically unexplained symptoms (MUS), similar to other afflictions, including irritable bowel syndrome (IBS), chronic fatigue syndrome (CFS), post-traumatic stress disorder (PTSD), Gulf War illness (GFI), and others. External environmental stimuli drive behavior and impact physiologic homeostasis (internal environment) via autonomic functioning. These environments directly impact the individual affective state (mind), which feeds back to regulate physiology (body). FMS has emerged as a complex disorder with pathologies identified among neurotransmitter and enzyme levels, immune/cytokine functionality, cortical volumes, cutaneous innervation, as well as an increased frequency among people with a history of traumatic and/or emotionally negative events, and specific personality trait profiles. Yet, quantitative physical evidence of pathology or disease etiology among FMS has been limited (as with other afflictions with MUS). Previously, our group published findings of increased peptidergic sensory innervation associated with the arterio-venous shunts (AVS) in the glabrous hand skin of FMS patients, which provides a plausible mechanism for the wide-spread FMS symptomology. This review focuses on FMS as a model affliction with MUS to discuss the implications of the recently discovered peripheral innervation alterations, explore the role of peripheral innervation to central sensitization syndromes (CSS), and examine possible estrogen-related mechanisms through which external and internal environmental factors may contribute to FMS etiology and possibly other afflictions with MUS.

  12. Seafarer fatigue

    DEFF Research Database (Denmark)

    Jepsen, Jørgen Riis; Zhao, Zhiwei; van Leeuwen, Wessel M. A.

    2015-01-01

    Background: The consequences of fatigue for the health and safety of seafarers has caused concern in the industry and among academics, and indicates the importance of further research into risk factors and preventive interventions at sea. This review gives an overview of the key issues relating...

  13. Climateric: fatigue or third stage of the general adaptation syndrome Climaterio: fatiga o tercera etapa del síndrome de adaptación general

    Directory of Open Access Journals (Sweden)

    William Alvarez Gaviria

    2004-09-01

    Full Text Available The origin of climacteric has been subject of debate. Most opinions agree in that it arises exclusively from natural selection. In this paper the author argues that, besides this reason there is another, even more important; for him, climacteric is the final response to fatigue or the third stage of the general adaptation syndrome, just as in elderly people there is a loss of the capacity of proliferation of fibroblasts and lack of response to insulin. From a genetic point of view, this corresponds to an antagonic pleiotropy: the genetic program that has made the human adrenergic and corticotropic systems hyperactive, has also caused that they do not reach senescence intact. High concentrations of stress hormones during youth and adulthood in humans, as compared to chimpanzees, gorillas and orangutans, and the hormonal cascade reactions elicited by them are meaningfully related to our most conspicuous illnesses, our genotype/phenotype and, in the long term, with climacteric. Se ha conjeturado a menudo sobre las razones del climaterio y la mayoría de los autores sostiene que es un fenómeno que surge exclusivamente de la selección natural. Aquí asumimos que, aunque esa sea parte de la explicación, no es la razón primordial. Así como con la edad se da la pérdida, por ejemplo, de la capacidad proliferativa de los fibroblastos y de la sensibilidad a la insulina, el climaterio podría corresponder no más que a la fatiga o tercera etapa del Síndrome de Adaptación General. En un enfoque genético correspondería, pues, a una pleiotropía antagónica: el programa genético que ha hecho hiperactivos a los sistemas adrenérgico y corticotrópico del ser humano, evitaría también que llegara incólume al punto final de senescencia. Las altas concentraciones de hormonas de estrés en la juventud y la edad adulta que distinguen a nuestra especie, comparada con el chimpancé, el gorila y el orangután, y las reacciones hormonales en cascada que

  14. Corrosion Fatigue

    Science.gov (United States)

    1981-10-01

    the applied protection systems, (2) crevices for moisture entrapment, (3) galvanic couples when steel or titanium fasteners are used, and (4) fatigue...Activ Material Structure Exposed Normal Environment* Unexposed Atmosphere Aluminum alloys Steel 1.25 2.0 4.0 Titanium " Magnesium " (4.0) (8.0) (10.0...APPRNDIX - Chromic Acid Anodizing The surface treatment consists in the following process : D egreasing with trichlorethylene vapor, * Pickling , Composition

  15. SM-03A RANDOMIZED, PLACEBO-CONTROLLED PILOT TRIAL OF ARMODAFINIL FOR FATIGUE IN PATIENTS WITH GLIOMAS UNDERGOING RADIOTHERAPY

    Science.gov (United States)

    Lee, Eudocia; Muzikansky, Alona; Kesari, Santosh; Wong, Eric; Fadul, Camilo; Reardon, David; Norden, Andrew; Nayak, Lakshmi; Rinne, Mikael; Alexander, Brian; Arvold, Nils; Doherty, Lisa; LaFrankie, Debra; Pulverenti, Julee; Smith, Katrina; Gaffey, Sarah; Kenney, Alexandra; Hammond, Samantha; Drappatz, Jan; Wen, Patrick

    2014-01-01

    BACKGROUND: Fatigue is a common symptom among glioma patients and affects quality of life. Armodafinil, a wakefulness-promoting medication, benefits patients with fatigue of various causes. This study evaluates the effects of armodafinil on fatigue in glioma patients undergoing radiation therapy (RT). METHODS: Eligibility criteria included age ≥ 18; KPS ≥ 60; grade 2-4 glioma undergoing RT to a total dose of 50-60 Gy with or without chemotherapy. Patients were randomized 1:1 to armodafinil or placebo. Fatigue assessments were made at baseline, Day 22, Day 43, and Day 56 with the FACIT-F Fatigue Scale, FACT-G, Brief Fatigue Inventory (BFI), and Cancer Fatigue Scale (CFS). The primary aim was to detect a difference in the 42-day change in FACIT-F fatigue subscale scores between the two groups using a 2-sample Wilcoxon statistic. Secondary outcomes include a 42-day change in FACT-G, CFS, and BFI. RESULTS: In the armodafinil arm, median age was 56 (25-79), median KPS was 90 (70-100), 58.5% with grade 4 glioma, 34.2% with grade 3 glioma, 2.4% with grade 2 glioma. In the placebo arm, median age was 54 (19-78), median KPS was 90 (70-100), 47.8% with grade 4 glioma, 30.8% with grade 3 glioma, 10.3% with grade 2 glioma. The median 42-day change in the FACIT-F fatigue subscale scores in the armodafinil arm was 1 (range -40 to 26) and in the placebo arm was -5.50 (range -65 to 28) with Wilcoxon p-value of 0.14. Toxicity was rare and similar between arms. CONCLUSIONS: Treatment with armodafinil is well tolerated in glioma patients undergoing RT. Preliminary results do not demonstrate statistically significant reduction in fatigue between groups. Updated results will be presented.

  16. St. John's Wort in Relieving Fatigue in Patients Undergoing Chemotherapy or Hormone Therapy for Cancer

    Science.gov (United States)

    2013-01-17

    Chronic Myeloproliferative Disorders; Fatigue; Leukemia; Lymphoma; Multiple Myeloma and Plasma Cell Neoplasm; Myelodysplastic Syndromes; Precancerous Condition; Unspecified Adult Solid Tumor, Protocol Specific

  17. MANAGING FATIGUE IN SPORTS

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    @@ Fatigue is a multifactorial process. Depletion of energy sources, including adenosine triphosphate (ATP), phosphocreatine (PCr), plus carbohydrates (CHO) like muscle glycogen and blood glucose can contribute to fatigue.

  18. High flow variant postural orthostatic tachycardia syndrome amplifies the cardiac output response to exercise in adolescents.

    Science.gov (United States)

    Pianosi, Paolo T; Goodloe, Adele H; Soma, David; Parker, Ken O; Brands, Chad K; Fischer, Philip R

    2014-08-01

    Postural orthostatic tachycardia syndrome (POTS) is characterized by chronic fatigue and dizziness and affected individuals by definition have orthostatic intolerance and tachycardia. There is considerable overlap of symptoms in patients with POTS and chronic fatigue syndrome (CFS), prompting speculation that POTS is akin to a deconditioned state. We previously showed that adolescents with postural orthostatic tachycardia syndrome (POTS) have excessive heart rate (HR) during, and slower HR recovery after, exercise - hallmarks of deconditioning. We also noted exaggerated cardiac output during exercise which led us to hypothesize that tachycardia could be a manifestation of a high output state rather than a consequence of deconditioning. We audited records of adolescents presenting with long-standing history of any mix of fatigue, dizziness, nausea, who underwent both head-up tilt table test and maximal exercise testing with measurement of cardiac output at rest plus 2-3 levels of exercise, and determined the cardiac output () versus oxygen uptake () relationship. Subjects with chronic fatigue were diagnosed with POTS if their HR rose ≥40 beat·min(-1) with head-up tilt. Among 107 POTS patients the distribution of slopes for the , relationship was skewed toward higher slopes but showed two peaks with a split at ~7.0 L·min(-1) per L·min(-1), designated as normal (5.08 ± 1.17, N = 66) and hyperkinetic (8.99 ± 1.31, N = 41) subgroups. In contrast, cardiac output rose appropriately with in 141 patients with chronic fatigue but without POTS, exhibiting a normal distribution and an average slope of 6.10 ± 2.09 L·min(-1) per L·min(-1). Mean arterial blood pressure and pulse pressure from rest to exercise rose similarly in both groups. We conclude that 40% of POTS adolescents demonstrate a hyperkinetic circulation during exercise. We attribute this to failure of normal regional vasoconstriction during exercise, such that patients must increase flow through an

  19. Effect of Meridian Massage for Cancer Related Fatigue

    Institute of Scientific and Technical Information of China (English)

    In sook Jeoung; Hwa-Seung Yoo

    2008-01-01

    The purpose of this study is to investigate the effectiveness of meridian massage in lessening the fatigue and improving both physical and mental quality of life of cancer patients. Settings and design: This study was conducted at the East-West Cancer Center at Daejeon University; Using a single-arm, waiting list and non-treatment control research design, we compared the results of control group and to that of the experimental group. Materials and methods: From July 2, 2007 to July 28, 2007, eighteen eligible cancer patients were recruited to participate in the experiment. Modified Chalder Fatigue Scale (CFS), Visual Analogue Scale (VAS) and active oxygen level were measured before and after treatment for both control and experimental groups. Lying on their back or stomach inside a room with a temperature of 18-2℃2, the patients received 30 minutes of meridian massages mainly around the trapezius muscles 5 times a week.Statistical analysis used: Data analysis was carried out using independent t-test, paired t-test and One-way ANOVA.Results: Data analysis of modified CFS showed statistically significant results for all groups between before and after treatment. Within CFS, results of physical and psychological analysis showed significant results for all groups except before and after no treatment and secondary treatment. In the analysis of VAS, the experimental group showed a greater decrease in score compared to that of the control group and the average difference was statistically significant (P<0.05). Although the results were not statistically significant (P>0.05), active oxygen levels for the control group showed little difference before and after no treatment (331.11 and 330.78, respectively) while the experimental group observed a decrease in active oxygen level before and after treatment (327.28 and 314.11, respectively). Conclusion: In conclusion, patients who received meridian massage showed decreased cancer related fatigue scores compared to the

  20. Level and appraisal of fatigue are not specific in burnout

    NARCIS (Netherlands)

    Dam, A. van; Keijsers, G.P.J.; Verbraak, M.J.P.M.; Eling, P.A.T.M.; Becker, E.S.

    2015-01-01

    Fatigue is a main feature of the burnout syndrome but also very common in other psychiatric disorders such as major depression and anxiety disorders. This raises the question of whether the level and appraisal of fatigue is experienced differently by individuals suffering from burnout than by those

  1. Level and appraisal of fatigue are not specific in burnout

    NARCIS (Netherlands)

    Dam, A. van; Keijsers, G.P.J.; Verbraak, M.J.P.M.; Eling, P.A.T.M.; Becker, E.S.

    2015-01-01

    Fatigue is a main feature of the burnout syndrome but also very common in other psychiatric disorders such as major depression and anxiety disorders. This raises the question of whether the level and appraisal of fatigue is experienced differently by individuals suffering from burnout than by those

  2. Fatigue life extension

    Science.gov (United States)

    Matejczyk, D. E.; Lin, J.

    1985-01-01

    Potential fatigue rejuvenation processes were carried out on fatigue-damaged material both with and without observable surface-connected fatigue cracks. The fatigue life of fatigue-damaged MAR-M246(Hf)(DS), a directionally solidified nickel-base superalloy used in turbine airfoils, was extended by reheat treatment. The fatigue life of fatigue-cracked Inconel 718, a wrought nickel-base superalloy used in a wide variety of advanced rocket engine components, was extended by electron-beam welding to close off the surface-connected crack, followed by hot isostatic pressing and reheat treatment.

  3. It’s more than dryness and fatigue: The patient perspective on health-related quality of life in Primary Sjögren’s Syndrome - A qualitative study

    Science.gov (United States)

    Lackner, Angelika; Ficjan, Anja; Stradner, Martin H.; Hermann, Josef; Unger, Julia; Stamm, Tanja; Stummvoll, Georg; Dür, Mona; Graninger, Winfried B.; Dejaco, Christian

    2017-01-01

    Objectives In Primary Sjögren’s Syndrome (PSS), there is an apparent lack of data concerning the perspectives of patients, their needs, preferences and difficulties of daily life. This qualitative study was conducted to explore perspectives and needs of patients with PSS that influence health related quality of life (HRQL). Methods We recruited 20 PSS patients fulfilling the American-European consensus classification criteria out of the PSS cohort of the Medical University Graz, Austria. In total, 6 focus group sessions (with three to four patients per group) were performed. A modified meaning condensation procedure was used to analyse the data. Results The interview analysis resulted in 484 meaning units, 254 subconcepts and 86 concepts. The identified concepts were grouped into three dimensions: physical dimension, psychological & emotional challenges and social life & daily living. A dependency between the three categories was identified. The concepts most commonly reported by patients were related to the physical dimension: pain and dryness as well as complaints associated with/provoked by these symptoms. Patients also reported shortness of breath, fatigue und constipation. Conclusions This qualitative study underpins that HRQL in PSS patients is affected by several factors. The problems are not limited to dryness, pain and fatigue while the complaints secondary to these symptoms are important to patients with PSS significantly affecting physical, psychological and social life components of HRQL. A disease-specific patient related outcome measures for clinical practice and trials should be developed considering the different aspects of HRQL in PSS. PMID:28182787

  4. HyCFS, a high-resolution shock capturing code for numerical simulation on hybrid computational clusters

    Science.gov (United States)

    Shershnev, Anton A.; Kudryavtsev, Alexey N.; Kashkovsky, Alexander V.; Khotyanovsky, Dmitry V.

    2016-10-01

    The present paper describes HyCFS code, developed for numerical simulation of compressible high-speed flows on hybrid CPU/GPU (Central Processing Unit / Graphical Processing Unit) computational clusters on the basis of full unsteady Navier-Stokes equations, using modern shock capturing high-order TVD (Total Variation Diminishing) and WENO (Weighted Essentially Non-Oscillatory) schemes on general curvilinear structured grids. We discuss the specific features of hybrid architecture and details of program implementation and present the results of code verification.

  5. 基于CFS-CPML边界处理的LOVE面波有限差分模拟%Finite difference modeling of Love waves based on CFS-CPML boundary processing

    Institute of Scientific and Technical Information of China (English)

    孙成禹; 闫月锋; 蓝阳

    2015-01-01

    建立近地表横波速度模型时通常需要用到面波分析的方法.Love面波是在低速层分界面附近传播的一种SH型不均匀平面波,本文利用高阶有限差分算子、合理的自由地表边界条件以及CFS-CPML吸收边界条件,获得了高精度的Love面波波场记录,并与传统的分裂式完全匹配层得到的波场记录作对比,体现了CFS-CPML吸收边界条件的优越性.在此基础上将数值模拟提取的频散特征与理论的频散特征进行对比,证明二者非常吻合,验证了Love面波有限差分模拟的精度很高,可以用来研究复杂情形下的Love面波频散特征,并分析了Love面波位移应力等一系列正演特征.

  6. Dynamic downscaling of 22-year CFS winter seasonal hindcasts with the UCLA-ETA regional climate model over the United States

    Science.gov (United States)

    De Sales, Fernando; Xue, Yongkang

    2013-07-01

    This study evaluates the UCLA-ETA regional model's dynamic downscaling ability to improve the National Center for Environmental Prediction Climate Forecast System (NCEP CFS), winter season predictions over the contiguous United States (US). Spatial distributions and temporal variations of seasonal and monthly precipitation are the main focus. A multi-member ensemble means of 22 winters from 1982 through 2004 are included in the study. CFS over-predicts the precipitation in eastern and western US by as much as 45 and 90 % on average compared to observations, respectively. Dynamic downscaling improves the precipitation hindcasts across the domain, except in the southern States, by substantially reducing the excessive precipitation produced by the CFS. Average precipitation root-mean-square error for CFS and UCLA-ETA are 1.5 and 0.9 mm day-1, respectively. In addition, downscaling improves the simulation of spatial distribution of snow water equivalent and land surface heat fluxes. Despite these large improvements, the UCLA-ETA's ability to improve the inter-annual and intra-seasonal precipitation variability is not clear, probably because of the imposed CFS' lateral boundary conditions. Preliminary analysis of the cause for the large precipitation differences between the models reveals that the CFS appears to underestimate the moisture flux convergence despite producing excessive precipitation amounts. Additionally, the comparison of modeled monthly surface sensible and latent heat fluxes with Global Land Data Assimilation System land data set shows that the CFS incorrectly partitioned most of surface energy into evaporation, unlike the UCLA-ETA. These findings suggest that the downscaling improvements are mostly due to a better representation of land-surface processes by the UCLA-ETA. Sensitivity tests also reveal that higher-resolution topography only played a secondary role in the dynamic downscaling improvement.

  7. Effects of individualized psychological intervention on postoperative fatigue syndrome among esophageal cancer patients%个体化心理干预对食管癌患者术后疲劳综合征的影响

    Institute of Scientific and Technical Information of China (English)

    栾琳琳; 殷静静; 段红香; 焦丽; 王功朝

    2013-01-01

    目的 探讨个体化心理干预对食管癌手术患者术后疲劳综合征(POFS)的影响.方法 将100例食管癌手术患者随机分为对照组及干预组各50例,对照组接受常规护理,干预组在其基础上予以个体化心理干预,包括针对性的个体评估、认知干预、情绪、症状护理及行为干预等,比较两组患者围术期疲劳、心境及术后早期康复等指标.结果 干预组术后疲劳程度显著轻于对照组,心境状态好于对照组(均P<0.05);两组术后自主下床、肛门排气、胸腔闭式引流、胃肠减压时间比较,差异有统计学意义(均P<0.01).结论 个体化心理干预有助于改善食管癌手术患者术后疲劳程度及心境状态,促进其早日康复.%Objective To investigate the effect of individualized psychological intervention on postoperative fatigue syndrome among e-sophageal cancer patients. Methods A total of 100 patients scheduled for esophageal tumor resection were commensurately and randomly assigned to two groups. The control group were given conventional nursing, while the intervention group additionally received individualized psychological intervention which involved individualized assessment, cognitive intervention, emotional intervention, symptomatic care and behavior intervention. Then patients perioperative fatigue and emotion status, early rehabilitation in the two groups were observed and compared. Results The scores of fatigue and emotion on the seventh and tenth day after operation in the intervention group significantly were lowered than in the control group(P<O. 05 for all). The time to voluntarily mobilize after surgery, the time to gas passage, duration of water seal chest drainage, and duration of gastric decompression between the 2 groups, had significant differences(P<0. 05 ,P<0. 01). Conclusion Individualized psychological intervention can effectively lessen fatigue levels of esophageal cancer patients, improve their emotion, and

  8. Fatigue and cardiorespiratory function following abdominal surgery.

    Science.gov (United States)

    Christensen, T; Bendix, T; Kehlet, H

    1982-07-01

    Subjective feelings of fatigue were assessed before operation and 10, 20 and 30 days after uncomplicated elective abdominal surgery in 16 otherwise healthy patients, using a constructed fatigue scale model. In addition, all patients had an orthostatic stress test performed at the same times. Six of the patients also underwent a bicycle ergometer test measuring heart rate and oxygen consumption. Subjective feelings of fatigue were increased (P less than 0.01) at all three postoperative observations, and only 5 of 16 patients returned to their preoperative level. The increased subjective feeling of fatigue correlated positively (RS = 0.53, P less than 0.001) with the increased pulse rate seen during orthostatic stress after operation. Heart rate was about 5 per cent higher (n.s.) after operation when bicycling at the same work loads, while oxygen consumption decreased by about 2 per cent (P less than 0.01) at all three postoperative bicycle tests. It is concluded that even electric uncomplicated abdominal surgery is followed by a pronounced feeling of fatigue, which may persist 1 month after surgery in about one-third of patients. The fatigue scale model seems applicable for future studies on the pathogenesis and treatment of the postoperative fatigue syndrome.

  9. Fatigue in Rheumatoid Arthritis.

    Science.gov (United States)

    Katz, Patricia

    2017-05-01

    The purpose of this study was to review the current information on fatigue in rheumatoid arthritis (RA). Severe fatigue is common among individuals with RA and has a significant impact on quality of life (QOL). RA-related factors (e.g., inflammation, pain) are associated with greater fatigue, but other factors, such as obesity, physical inactivity, sleep disturbance, and depression, explain the majority of variation in fatigue. Medications targeting RA have little effect on fatigue. Instead, the most effective interventions seem to address non-RA-specific factors such as physical inactivity or use cognitive behavioral approaches. No recommendations have been made for tools to measure fatigue in RA, leading to potential difficulty comparing studies. Although fatigue has great impact on patients' QOL, effective interventions that are feasible for broad dissemination remain elusive. Additional multi-faceted research is needed to identify modifiable sources of fatigue. Such research would be enhanced by harmonization of fatigue measurement across studies.

  10. DHEA

    Science.gov (United States)

    ... multiple sclerosis (MS), low levels of steroid hormones (Addison's disease), depression, schizophrenia, chronic fatigue syndrome (CFS), muscle damage ... Sjögren's syndrome that causes symptoms including dry mouth. Addison's disease. Research about the effects of DHEA on Addison's ...

  11. Thermal Acoustic Fatigue Apparatus

    Data.gov (United States)

    Federal Laboratory Consortium — The Thermal Acoustic Fatigue Apparatus (TAFA) is a progressive wave tube test facility that is used to test structures for dynamic response and sonic fatigue due to...

  12. Insomnia and Fatigue

    Science.gov (United States)

    ... Styles Common Yoga Poses Special Situations Yoga and Lymphedema Risk Yoga and Metastatic Breast Cancer Side Effects ... Insomnia and Fatigue Treatment for Insomnia and Fatigue Lymphedema Lymphedema Risk Treating Lymphedema Menopausal Symptoms Mouth Sores ...

  13. Dynamic downscaling of CFS winter seasonal simulations over the United States using the ETA/SSIB-3 model

    Science.gov (United States)

    de Sales, F.; Xue, Y.

    2010-12-01

    The NCEP ETA/SSiB-3 regional circulation model (RCM) was 1-way nested in the NCEP Climate Forecast System (CFS) for a series of 22-year downscaling simulations of the winter season (December through April) over North America from 1982 through 2003. Each year’ simulation has 5 ensemble members producing a total of 110 winter hindcasts. These simulations are part of the Multi-RCM Ensemble Downscaling (MRED), which aims to explore the utility and value of RCMs in operational seasonal to interannual climate prediction. The Eta/SSiB-3 shows good downscaling ability for seasonal mean precipitation. The model reproduced well the winter precipitation pattern over the country, especially the high precipitation regions; over the East, the Northwest, and central California, with a large drier region in between. The RCM, however, did not simulate the precipitation maximum over the Southeast, which was well captured by the global model. The December-January-February-March-April (DJFMA) of 22-year mean bias averaged over the whole country for the CFS is 1.52 mm day-1, while for the ETA-SSIB-3 model it is -0.1 mm day-1. Similar comparison yielded a 66.7% reduction in RMSE of precipitation with downscaling. The analysis of average precipitation time series indicates that overall the RCM improved the simulation by reducing excessive rainfall produced by the GCM, especially over the western states. RCM reduced the countrywide CFS’ RMSE of time series from 1.60 to 0.33 mm day-1. The error reduction was larger over the western states (nearly 83%) than over the eastern states (approximately 67%). However, the temporal correlation with observation shows little difference between GCM and RCM, indicating the dominant role of lateral boundary forcing from CFS in producing the temporal variability. The simulation of seasonal snow water equivalent was also improved by the regional model. Comparison between models simulations and the Rutgers University observational data shows that the

  14. Cfs1p, a Novel Membrane Protein in the PQ-Loop Family, Is Involved in Phospholipid Flippase Functions in Yeast

    Directory of Open Access Journals (Sweden)

    Takaharu Yamamoto

    2017-01-01

    Full Text Available Type 4 P-type ATPases (P4-ATPases function as phospholipid flippases, which translocate phospholipids from the exoplasmic leaflet to the cytoplasmic leaflet of the lipid bilayer, to generate and maintain asymmetric distribution of phospholipids at the plasma membrane and endosomal/Golgi membranes. The budding yeast Saccharomyces cerevisiae has four heteromeric flippases (Drs2p, Dnf1p, Dnf2p, and Dnf3p, associated with the Cdc50p family noncatalytic subunit, and one monomeric flippase, Neo1p. They have been suggested to function in vesicle formation in membrane trafficking pathways, but details of their mechanisms remain to be clarified. Here, to search for novel factors that functionally interact with flippases, we screened transposon insertional mutants for strains that suppressed the cold-sensitive growth defect in the cdc50Δ mutant. We identified a mutation of YMR010W encoding a novel conserved membrane protein that belongs to the PQ-loop family including the cystine transporter cystinosin and the SWEET sugar transporters. We named this gene CFS1 (cdc fifty suppressor 1. GFP-tagged Cfs1p was partially colocalized with Drs2p and Neo1p to endosomal/late Golgi membranes. Interestingly, the cfs1Δ mutation suppressed growth defects in all flippase mutants. Accordingly, defects in membrane trafficking in the flippase mutants were also suppressed. These results suggest that Cfs1p and flippases function antagonistically in membrane trafficking pathways. A growth assay to assess sensitivity to duramycin, a phosphatidylethanolamine (PE-binding peptide, suggested that the cfs1Δ mutation changed PE asymmetry in the plasma membrane. Cfs1p may thus be a novel regulator of phospholipid asymmetry.

  15. Optimal Fatigue Testing

    DEFF Research Database (Denmark)

    Faber, M. H.; Sørensen, John Dalsgaard; Kroon, I. B.

    1993-01-01

    This paper considers the reassessment of the reliability of tubular joints subjected to fatigue load. The reassessment is considered in two parts namely the task of utilizing new experimental data on fatigue life to update the reliability of the tubular joint ant the task of planning new fatigue ...

  16. Discerning Primary and Secondary Factors Responsible for Clinical Fatigue in Multisystem Diseases

    Directory of Open Access Journals (Sweden)

    David Maughan

    2014-09-01

    Full Text Available Fatigue is a common symptom of numerous acute and chronic diseases, including myalgic encephalomyelitis/chronic fatigue syndrome, multiple sclerosis, heart failure, cancer, and many others. In these multi-system diseases the physiological determinants of enhanced fatigue encompass a combination of metabolic, neurological, and myofibrillar adaptations. Previous research studies have focused on adaptations specific to skeletal muscle and their role in fatigue. However, most have neglected the contribution of physical inactivity in assessing disease syndromes, which, through deconditioning, likely contributes to symptomatic fatigue. In this commentary, we briefly review disease-related muscle phenotypes in the context of whether they relate to the primary disease or whether they develop secondary to reduced physical activity. Knowledge of the etiology of the skeletal muscle adaptations in these conditions and their contribution to fatigue symptoms is important for understanding the utility of exercise rehabilitation as an intervention to alleviate the physiological precipitants of fatigue.

  17. Fatigue Damage in Wood

    DEFF Research Database (Denmark)

    Clorius, Christian Odin; Pedersen, Martin Bo Uhre; Hoffmeyer, Preben;

    1996-01-01

    An investigation of fatigue failure in wood subjected to load cycles in compression parallel to grain is presented. Fatigue failure is found to depend both on the total time under load and on the number of cycles.Recent accelerated fatigue research on wood is reviewed, and a discrepancy between...... failure explanation under fatigue and static load conditions is observed. In the present study small clear specimens of spruce are taken to failure in square wave formed fatigue loading at a stress excitation level corresponding to 80% of the short term strength. Four frequencies ranging from 0.01 Hz...... to 10 Hz are used. The number of cycles to failure is found to be a poor measure of the fatigue performance of wood. Creep, maximum strain, stiffness and work are monitored throughout the fatigue tests. Accumulated creep is suggested identified with damage and a correlation between stiffness reduction...

  18. Multiaxial fatigue low cycle fatigue testing

    Science.gov (United States)

    Zamrik, S. Y.

    1985-01-01

    Multiaxial testing methods are reviewed. Advantages and disadvantages of each type test is discussed. Significant multiaxial data available in the literature is analyzed. The yield theories are compared for multiaxial fatigue analysis.

  19. Physiological and neurophysiological determinants of postcancer fatigue: design of a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Prinsen Hetty

    2012-06-01

    Full Text Available Abstract Background Postcancer fatigue is a frequently occurring, severe, and invalidating problem, impairing quality of life. Although it is possible to effectively treat postcancer fatigue with cognitive behaviour therapy, the nature of the underlying (neurophysiology of postcancer fatigue remains unclear. Physiological aspects of fatigue include peripheral fatigue, originating in muscle or the neuromuscular junction; central fatigue, originating in nerves, spinal cord, and brain; and physical deconditioning, resulting from a decreased cardiopulmonary function. Studies on physiological aspects of postcancer fatigue mainly concentrate on deconditioning. Peripheral and central fatigue and brain morphology and function have been studied for patients with fatigue in the context of chronic fatigue syndrome and neuromuscular diseases and show several characteristic differences with healthy controls. Methods/design Fifty seven severely fatigued and 21 non-fatigued cancer survivors will be recruited from the Radboud University Nijmegen Medical Centre. Participants should have completed treatment of a malignant, solid tumour minimal one year earlier and should have no evidence of disease recurrence. Severely fatigued patients are randomly assigned to either the intervention condition (cognitive behaviour therapy or the waiting list condition (start cognitive behaviour therapy after 6 months. All participants are assessed at baseline and the severely fatigued patients also after 6 months follow-up (at the end of cognitive behaviour therapy or waiting list. Primary outcome measures are fatigue severity, central and peripheral fatigue, brain morphology and function, and physical condition and activity. Discussion This study will be the first randomized controlled trial that characterizes (neurophysiological factors of fatigue in disease-free cancer survivors and evaluates to which extent these factors can be influenced by cognitive behaviour therapy

  20. Compassion fatigue in nurses.

    Science.gov (United States)

    Yoder, Elizabeth A

    2010-11-01

    Compassion fatigue, trigger situations, and coping strategies were investigated in hospital and home care nurses. The Professional Quality of Life Scale measured compassion fatigue, compassion satisfaction, and burnout. Narrative questions elicited trigger situations and coping strategies. Compassion fatigue scores were significantly different between nurses who worked 8- or 12-hour shifts. Fifteen percent of the participants had scores indicating risk of the compassion fatigue. There were significant differences in compassion satisfaction, depending on the unit worked and time as a nurse. The most common category of trigger situations was caring for the patient. Work-related and personal coping strategies were identified. Copyright © 2010 Elsevier Inc. All rights reserved.

  1. Post-Polio Syndrome

    Science.gov (United States)

    ... or fatigue, this may overwork already stressed-out motor neurons and increase your risk of post-polio syndrome. Generally, post-polio syndrome is rarely life-threatening, but severe muscle weakness can lead to complications: Falls. Weakness in your leg muscles makes it ...

  2. Managing Sjogren's Syndrome.

    Science.gov (United States)

    Grossman, Sheila; Tagliavini, Lynda B

    2015-10-01

    There are approximately 4 million Americans diagnosed with Sjogren's Syndrome. This article discusses the epidemiology, pathophysiology, diagnostics, and implications for home care clinicians who may encounter patients with this syndrome. Chronic pain is discussed as well as interventions to manage symptoms such fatigue, dry eyes mouth and skin.

  3. Myth vs. Fact: Adrenal Fatigue

    Science.gov (United States)

    ... unlikely to cover the costs. What is the theory behind adrenal fatigue? Supporters of adrenal fatigue believe ... by producing hormones like cortisol. According to the theory of adrenal fatigue, when people are faced with ...

  4. Theoretical Accounts of Gulf War Syndrome: From Environmental Toxins to Psychoneuroimmunology and Neurodegeneration

    Directory of Open Access Journals (Sweden)

    Eamonn Ferguson

    2002-01-01

    Full Text Available Non-specific illness includes a wide variety of symptoms: behavioural (e.g., reduced food and water intake, cognitive (e.g., memory and concentration problems and physiological (e.g., fever. This paper reviews evidence suggesting that such symptoms can be explained more parsimoniously as a single symptom cluster than as a set of separate illnesses such as Gulf War Syndrome (GWS and chronic fatigue syndrome (CFS. This superordinate syndrome could have its biological basis in the activity of pro-inflammatory cytokines (in particular interleukin-1: IL-1, that give rise to what has become known as the ‘sickness response’. It is further argued that the persistence of non-specific illness in chronic conditions like GWS may be (in part attributable to a bio-associative mechanism (Ferguson and Cassaday, 1999. In the case of GWS, physiological challenges could have produced a non-specific sickness response that became associated with smells (e.g., petrol, coincidentally experienced in the Persian Gulf. On returning to the home environment, these same smells would act as associative triggers for the maintenance of (conditioned sickness responses. Such associative mechanisms could be mediated through the hypothalamus and limbic system via vagal nerve innervation and would provide an explanation for the persistence of a set of symptoms (e.g., fever that should normally be short lived and self-limiting. We also present evidence that the pattern of symptoms produced by the pro-inflammatory cytokines reflects a shift in immune system functioning towards a (T-helper-1 Th1 profile. This position contrasts with other immunological accounts of GWS that suggest that the immune system demonstrates a shift to a Th2 (allergy profile. Evidence pertaining to these two contrasting positions is reviewed.

  5. Self-regulatory fatigue in chronic multisymptom illnesses: scale development, fatigue, and self-control.

    Science.gov (United States)

    Nes, Lise Solberg; Ehlers, Shawna L; Whipple, Mary O; Vincent, Ann

    2013-01-01

    Self-regulatory capacity involves ability to regulate thoughts, emotions, and behavior. Chronic multisymptom illnesses such as fibromyalgia and chronic fatigue syndrome are accompanied by numerous challenges, and have recently been associated with self-regulatory fatigue (SRF). Chronic multisymptom illnesses are also frequently associated with physical fatigue, and through development of a scale measuring SRF, the current study aimed to examine how SRF can be distinguished from physical fatigue. The study also sought to distinguish SRF from self-control. Two self-regulation researchers developed 30 items related to self-regulatory capacity. These items were distributed to patients (n = 296) diagnosed with chronic multisymptom illness together with validated measures of physical fatigue and self-control. A principal factor analysis was employed to examine factor structures, identify inter-item relationships, and aid in scale development. The final proposed scale consisted of 18 items measuring self-regulatory capacity (SRF-18) with cognitive, emotional, and behavioral SRF components. Internal consistency and reliability was acceptable (Cronbach's á = 0.81). The final scale was moderately correlated with self-control (r = -0.48) and highly correlated with physical fatigue (r = 0.75), although more so with emotional (r = 0.72) and mental (r = 0.65) than physical (r = 0.46) fatigue components. The current study suggests a new scale for measurement of SRF in chronic multisymptom illness. Although cross-validation studies are necessary, such a scale may contribute to a better understanding of the concept of self-regulation and the role of SRF in chronic illness. Although related to physical fatigue and self-control, the results point to SRF as a distinct construct.

  6. L-carnitine ameliorated fasting-induced fatigue, hunger, and metabolic abnormalities in patients with metabolic syndrome: a randomized controlled study

    OpenAIRE

    Zhang, Jun-Jie; Wu, Zhi-bing; Cai, You-jin; Ke, Bin; Huang, Ying-juan; Qiu, Chao-ping; Yang, Yu-bing; Shi, Lan-Ying; QIN, JIAN

    2014-01-01

    Background The present study aimed to determine that whether L-carnitine infusion could ameliorate fasting-induced adverse effects and improve outcomes. Method In this 7-day, randomized, single-blind, placebo-controlled, pilot study, 15 metabolic syndrome (MetS) patients (11/4 F/M; age 46.9 ± 9.14 years; body mass index [BMI] 28.2 ± 1.8 kg/m2) were in the L-carnitine group (LC) and 15 (10/5 F/M; age 46.8 ± 10.9 years; BMI 27.1 ± 2.3 kg/m2) were in the control group (CT). All participants unde...

  7. Examining fatigue in COPD

    DEFF Research Database (Denmark)

    Al-Shair, Khaled; Muellerova, Hana; Yorke, Janelle

    2012-01-01

    ABSTRACT: INTRODUCTION: Fatigue is a disruptive symptom that inhibits normal functional performance of COPD patients in daily activities. The availability of a short, simple, reliable and valid scale would improve assessment of the characteristics and influence of fatigue in COPD. METHODS......: At baseline, 2107 COPD patients from the ECLIPSE cohort completed the Functional Assessment of Chronic Illness Therapy Fatigue (FACIT-F) scale. We used well-structured classic method, the principal components analysis (PCA) and Rasch analysis for structurally examining the 13-item FACIT-F. RESULTS: Four items...... were less able to capture fatigue characteristics in COPD and were deleted. PCA was applied to the remaining 9 items of the modified FACIT-F and resulted in three interpretable dimensions: i) general (5 items); ii) functional ability (2 items); and iii) psychosocial fatigue (2 items). The modified...

  8. Compressive Fatigue in Wood

    DEFF Research Database (Denmark)

    Clorius, Christian Odin; Pedersen, Martin Bo Uhre; Hoffmeyer, Preben;

    1999-01-01

    An investigation of fatigue failure in wood subjected to load cycles in compression parallel to grain is presented. Small clear specimens of spruce are taken to failure in square wave formed fatigue loading at a stress excitation level corresponding to 80% of the short term strength. Four...... frequencies ranging from 0.01 Hz to 10 Hz are used. The number of cycles to failure is found to be a poor measure of the fatigue performance of wood. Creep, maximum strain, stiffness and work are monitored throughout the fatigue tests. Accumulated creep is suggested identified with damage and a correlation...... is observed between stiffness reduction and accumulated creep. A failure model based on the total work during the fatigue life is rejected, and a modified work model based on elastic, viscous and non-recovered viscoelastic work is experimentally supported, and an explanation at a microstructural level...

  9. The effect of TiO2 nanoparticles removal on drinking water quality produced by conventional treatment C/F/S.

    Science.gov (United States)

    Serrão Sousa, Vânia; Corniciuc, Claudia; Ribau Teixeira, Margarida

    2017-02-01

    Nanoparticles, namely titanium dioxide (TiO2), are emerging contaminants widely used to commercial and industrial applications, are a potential hazard and can cause damage to environment and human health due to their toxicity. Therefore, their removal from the water is urgent to minimize or eliminate the adverse environmental and human effects. This work, investigates the efficiency of conventional coagulation/flocculation/sedimentation (C/F/S) from drinking water treatment to remove TiO2 nanoparticles (NPs) from surface waters, and pretends to understand if the removal of TiO2 NPs affects the ability of C/F/S to remove natural organic matter (NOM) and turbidity, and consequently affects the quality of the treated water. Results show that TiO2 NPs removal is high (>90%) for all the waters studied (hydrophobic and hydrophilic waters) and the treated water quality is not compromised (turbidity, Ti and Al concentrations, pH and conductivity are below the national and international guidelines). In addition, TiO2 initial concentrations, ranging between 0.2 and 10 mg/L, have not a significant impact on NPs removal by C/F/S. Therefore, the widely used polyaluminium based coagulants are effective in the removal of TiO2 NPs by conventional C/F/S treatment, but removal is strongly influenced by the water characteristics. Hydrophobic waters need a higher coagulant dose than hydrophilic waters to achieve the same TiO2 NPs removals, as well as water with higher UV254nm values. The principal mechanism involved in TiO2 NPs removal is charge neutralisation.

  10. 克维尼亚食品机械系统有限公司(CFS)兼并迪西尤年公司(Dixie Union)

    Institute of Scientific and Technical Information of China (English)

    2000-01-01

    @@ 2000年5月3日,克维尼亚食品机械系统有限公司(CFS)正式宣布兼并SUIZA食品集团公司的迪西尤年公司(Dixie Union).Dixie公司主要生产切片机,深拉伸包装机和包装材料.

  11. Level and appraisal of fatigue are not specific in burnout

    NARCIS (Netherlands)

    van Dam, A.; Keijsers, G.P.J.; Verbraak, M.J.P.M.; Eling, P.A.T.M.; Becker, E. S.

    2015-01-01

    Fatigue is a main feature of the burnout syndrome but also very common in other psychiatric disorders such as major depression and anxiety disorders. This raises the question of whether the level and appraisal of fatigue is experienced differently by individuals suffering from burnout than by those

  12. Fatigue Management (La Gestion de la Fatigue)

    Science.gov (United States)

    1991-12-01

    Management Pre’face Etant donne la tenidance de plus en plus marque ~e vets le maintien en service des aironefs au-delak des dates lintites...transport aircraft designed prototype sade its first flight one year about 20 years ago; from the fatigue point later. The results of the flight testing

  13. Fatigue evaluation algorithms: Review

    Energy Technology Data Exchange (ETDEWEB)

    Passipoularidis, V.A.; Broendsted, P.

    2009-11-15

    A progressive damage fatigue simulator for variable amplitude loads named FADAS is discussed in this work. FADAS (Fatigue Damage Simulator) performs ply by ply stress analysis using classical lamination theory and implements adequate stiffness discount tactics based on the failure criterion of Puck, to model the degradation caused by failure events in ply level. Residual strength is incorporated as fatigue damage accumulation metric. Once the typical fatigue and static properties of the constitutive ply are determined,the performance of an arbitrary lay-up under uniaxial and/or multiaxial load time series can be simulated. The predictions are validated against fatigue life data both from repeated block tests at a single stress ratio as well as against spectral fatigue using the WISPER, WISPERX and NEW WISPER load sequences on a Glass/Epoxy multidirectional laminate typical of a wind turbine rotor blade construction. Two versions of the algorithm, the one using single-step and the other using incremental application of each load cycle (in case of ply failure) are implemented and compared. Simulation results confirm the ability of the algorithm to take into account load sequence effects. In general, FADAS performs well in predicting life under both spectral and block loading fatigue. (author)

  14. Pregnancy-induced Hypertension Syndrome Combined Contractions Fatigue Analysis of the Nursing Countermeasure of Postpartum Hemorrhage%妊娠高血压综合症合并宫缩乏力性产后出血的护理对策分析

    Institute of Scientific and Technical Information of China (English)

    覃京珠

    2015-01-01

    目的:探讨妊娠高血压综合征患者合并宫缩乏力性产后出血的护理对策。方法收集100例妊娠高血压综合征合并宫缩乏力性后出血患者,随机分为观察组和对照组,各50例。结果两组患者在经过护理后均有一定的效果,但观察组患者的护理效果明显优于对照组患者,有统计学差异。结论在对妊娠高血压综合征合并宫缩乏力性产后出血患者进行临床护理的过程中,使用护理干预的护理方法能够显著提升护理效果。%Objective To explore the patients with pregnancy-induced hypertension syndrome with contractions fatigue sex nursing countermeasures of postpartum hemorrhage. Methods Collecting 100 cases of pregnancy-induced hypertension syndrome patients with bleeding after the merger contractions fatigue sex, were randomly divided into observation group and control group, 50 cases each.Results Two groups of patients after nursing all have certain effect, but the observation group of patients with nursing effect was better than control group patients, statistically significant.Conclusion In clinical of pregnancy-induced hypertension syndrome complicated contractions fatigue sex in the process of postpartum hemorrhage patients for nursing care, the nursing methods of using the nursing intervention can signiifcantly improve the nursing effect.

  15. Experiences of Fatigue at Sea

    DEFF Research Database (Denmark)

    Zhao, Zhiwei; Jepsen, Jørgen Riis; Chen, Zhonglong

    2016-01-01

    Fatigue has negative impacts on the general working population as well as on seafarers. In order to study seafarers’ fatigue, a questionnaire-base survey was conducted to gain information about potential risk factors for fatigue and construct indexes indicating fatigue. The study applies T-test t...

  16. Prolonged unexplained fatigue in paediatrics

    NARCIS (Netherlands)

    Bakker, R.J.

    2010-01-01

    Prolonged Unexplained Fatigue in Paediatrics. Fatigue, as the result of mental or physical exertion, will disappear after rest, drinks and food. Fatigue as a symptom of illness will recover with the recovering of the illness. But when fatigue is ongoing for a long time, and not the result of exertio

  17. Experiences of Fatigue at Sea

    DEFF Research Database (Denmark)

    Zhao, Zhiwei; Jepsen, Jørgen Riis; Chen, Zhonglong;

    2016-01-01

    Fatigue has negative impacts on the general working population as well as on seafarers. In order to study seafarers’ fatigue, a questionnaire-base survey was conducted to gain information about potential risk factors for fatigue and construct indexes indicating fatigue. The study applies T...

  18. Metabolic Factors in Fatigue

    Institute of Scientific and Technical Information of China (English)

    Mark Hargreaves

    2006-01-01

    Increased non-oxidative and oxidative ATP production via metabolic pathways in skeletal muscle is essential for the maintenance of force and power production during exercise. However, substrate depletion and accumulation of metabolic byproducts are potential causes of fatigue. Reduced PCr availability can limit power production during sprint exercise, whereas carbohydrate depletion is a major limitation to endurance performance. During sprint exercise increased Pi and H+ may contribute to fatigue, and during prolonged strenuous exercise, the accumulation of NH3, reactive oxygen species, and heat can limit performance. Appropriate training programs and nutritional interventions are potential strategies to enhance fatigue resistance and exercise performance.

  19. Fatigue 󈨛. Volume 2,

    Science.gov (United States)

    1987-06-01

    fatigue cracks grown in a nominally elastic field. EXPERIMENTAL DETAILS A low alloy steel (QIN) with a composition closely similar to HY80 , i.e. 2.5...Prediction of Steel Cords - A. PRAKASH, 645 G.A. COSTELLO, R.M. SHEMENSKI AND D.K. KIM Effect of Hold Time on Fatigue of Lead Rich 655 PbSn Solder...S. VAYNMAN, M.E. FINE AND D.A. JEANNOTTE On Cleavage in Fatigue for Rail Steels - 667 ZHU DONG, CAI QIGONG and YAO HENG Influence of Cleavage on

  20. Hyperthermia and fatigue

    DEFF Research Database (Denmark)

    Nybo, Lars

    2008-01-01

    of the cardiovascular function, which eventually reduces arterial oxygen delivery to the exercising muscles. Accordingly, aerobic energy turnover is impaired and anaerobic metabolism provokes peripheral fatigue. In contrast, metabolic disturbances of muscle homeostasis are less important during prolonged exercise......The present review addresses mechanisms of importance for hyperthermia-induced fatigue during short intense activities and prolonged exercise in the heat. Inferior performance during physical activities with intensities that elicit maximal oxygen uptake is to a large extent related to perturbation...... of the dopaminergic system, but may primarily relate to inhibitory signals from the hypothalamus arising secondary to an increase in brain temperature. Fatigue is an integrated phenomenon, and psychological factors, including the anticipation of fatigue, should not be neglected and the interaction between central...

  1. Fatigue Evaluation Algorithms: Review

    DEFF Research Database (Denmark)

    Passipoularidis, Vaggelis; Brøndsted, Povl

    A progressive damage fatigue simulator for variable amplitude loads named FADAS is discussed in this work. FADAS (Fatigue Damage Simulator) performs ply by ply stress analysis using classical lamination theory and implements adequate stiffness discount tactics based on the failure criterion of Puck......, to model the degradation caused by failure events in ply level. Residual strength is incorporated as fatigue damage accumulation metric. Once the typical fatigue and static properties of the constitutive ply are determined,the performance of an arbitrary lay-up under uniaxial and/or multiaxial load time...... blade construction. Two versions of the algorithm, the one using single-step and the other using incremental application of each load cycle (in case of ply failure) are implemented and compared. Simulation results confirm the ability of the algorithm to take into account load sequence effects...

  2. Fatigue in soccer

    DEFF Research Database (Denmark)

    Mohr, Magni; Krustrup, Peter; Bangsbo, Jens

    2005-01-01

    This review describes when fatigue may develop during soccer games and the potential physiological mechanisms that cause fatigue in soccer. According to time?-?motion analyses and performance measures during match-play, fatigue or reduced performance seems to occur at three different stages......, acidity or the breakdown of creatine phosphate. Instead, it may be related to disturbances in muscle ion homeostasis and an impaired excitation of the sarcolemma. Soccer players' ability to perform maximally is inhibited in the initial phase of the second half, which may be due to lower muscle...... concentrations in a considerable number of individual muscle fibres. In a hot and humid environment, dehydration and a reduced cerebral function may also contribute to the deterioration in performance. In conclusion, fatigue or impaired performance in soccer occurs during various phases in a game, and different...

  3. Fatigue Crack Topography.

    Science.gov (United States)

    1984-01-01

    evaluating ciack initiation time and crack propagation, prgram I was used for performing the major fatigue test with the aircraft structure. In...advantage to begin with the end of the fracture, this is especially so in the case of the quantitative evaluation of striations. The overload fracture...Select the Measuring Line for Quantitative Evaluation Actually, the fatigue fracture should be inspected completely from the point of origin to the

  4. The Recognition Of Fatigue

    DEFF Research Database (Denmark)

    Elsass, Peter; Jensen, Bodil; Mørup, Rikke;

    2007-01-01

    Elsass P., Jensen B., Morup R., Thogersen M.H. (2007). The Recognition Of Fatigue: A qualitative study of life-stories from rehabilitation clients. International Journal of Psychosocial Rehabilitation. 11 (2), 75-87......Elsass P., Jensen B., Morup R., Thogersen M.H. (2007). The Recognition Of Fatigue: A qualitative study of life-stories from rehabilitation clients. International Journal of Psychosocial Rehabilitation. 11 (2), 75-87...

  5. Driver Fatigue Features Extraction

    Directory of Open Access Journals (Sweden)

    Gengtian Niu

    2014-01-01

    Full Text Available Driver fatigue is the main cause of traffic accidents. How to extract the effective features of fatigue is important for recognition accuracy and traffic safety. To solve the problem, this paper proposes a new method of driver fatigue features extraction based on the facial image sequence. In this method, first, each facial image in the sequence is divided into nonoverlapping blocks of the same size, and Gabor wavelets are employed to extract multiscale and multiorientation features. Then the mean value and standard deviation of each block’s features are calculated, respectively. Considering the facial performance of human fatigue is a dynamic process that developed over time, each block’s features are analyzed in the sequence. Finally, Adaboost algorithm is applied to select the most discriminating fatigue features. The proposed method was tested on a self-built database which includes a wide range of human subjects of different genders, poses, and illuminations in real-life fatigue conditions. Experimental results show the effectiveness of the proposed method.

  6. Detection of Xenotropic Murine Leukemia Virus Related Virus (XMRV) in Gulf War Illness: Role in Pathogenesis or Biomarker?

    Science.gov (United States)

    2013-10-01

    The etiology of CFS may be viral or immunologic. Neurasthenia and fibromyalgia may represent related disorders. Also known as myalgic...Encephalomyelitis    (ME)/Chronic   Fatigue  Syndrome  (CFS)   □Yes   □No       Fibromyalgia   □Yes   □No       Gulf

  7. The adolescent experience in Juvenile Idiopathic Arthritis: A narrative approach

    NARCIS (Netherlands)

    Fuchs, C.E.|info:eu-repo/dai/nl/304820369

    2013-01-01

    This dissertation focused on the self-experience of adolescents with juvenile idiopathic arthritis (JIA) or chronic fatigue syndrome (CFS). Although the etiology and nosology of JIA and CFS are fundamentally different, some commonalities in the emotional experience of adolescents dealing with these

  8. Exercise Fatigue in Adolescents: Diagnosis of Athlete Burnout.

    Science.gov (United States)

    Rowland, Thomas W.

    1986-01-01

    Chronic fatigue, declining performance, and mental lassitude, all symptoms of athlete burnout syndrome, require a comprehensive diagnostic approach. Many factors which can interfere with normal exercise capacity are easily treatable so a careful search is important. Three case studies are presented. (Author/MT)

  9. 中学生慢性疲劳综合症所致学校拒绝的现况调查%Cross-sectional study on children chronic fatigue syndrome-school refusal among middle school students

    Institute of Scientific and Technical Information of China (English)

    武丽杰; 孙彩虹; 夏薇; 王海莲; 陈素芬

    2007-01-01

    [目的] 引进日本儿童慢性疲劳综合症(children chronic fatigue syndrome,CCFS)所致学校拒绝(不登校)的诊断基准并初步探讨国内中学生慢性疲劳综合症所致学校拒绝的发生现况.[方法] 分层整群抽取哈尔滨市三个城区初中一年级至高中三年级、年龄在11.30~21.63岁的1 294名学生进行横断面调查. [结果] ①在所调查样本中,发生睡眠问题及慢性疲劳相关症状的检出率分别为43.82%和48.38%,初、高中生及不同性别间差异无显著性(P>0.05);②中学生发生不同睡眠问题的检出率从高到低依次为晨起困难、入睡困难、嗜睡、夜间醒来的次数增加、睡眠时间颠倒以及失眠等;发生与慢性疲劳相关的不同症状检出率从高到低依次为注意力及记忆力低下、全身疲劳倦怠感、头痛头重、咽喉痛、肌肉无力、眩晕、肌肉痛等;③在647名有睡眠障碍及慢性疲劳相关症状的学生中,有6.1%的学生符合日本儿童慢性疲劳综合症所致学校拒绝的诊断基准,有一定比例的中学生有不同程度的学校状况不良.[结论] 国内中学生由慢性疲劳所致的学校拒绝现况也较严重,应引起足够的警惕和重视.

  10. Influence of Different Body Mass Indexes on Joint Pain, Fatigue and Life Quality of Women with Fibromyalgia Syndrome%不同体质量指数的纤维肌痛综合征妇女的关节疼痛、疲劳以及生活质量的分析

    Institute of Scientific and Technical Information of China (English)

    叶小燕; 谷欣; 张燕青

    2015-01-01

    Objective To investigate the influence of different body mass indexes ( BMI) on joint pain, fatigue and life quality of women with fibromyalgia syndrome. Methods A total of 88 women with fibromyalgia syndrome admit-ted during June 2012 and December 2013 were divided into group A (BMI24, n=32). The values of joint pain evaluated with visual analogue scale (VAS), 5 points of visual analogue range scale questionnaire ( VARS-5 ) , incidence rates of frozen pain and fatigue and life quality and health questionnaire (SF -16) of 3 groups were compared. Results Scores of VAS and VARS -5 and incidence rates of frozen pain and fatigue in group B were significantly lower than those in group A and group C, and the values in group A were also significantly lower than those in group C (P24)。比较3组关节疼痛的视觉模拟评分(VAS)和5点口述疼痛评分问卷(VARS-5)得分、僵痛和疲劳情况、生活质量健康调查问卷(SF-16)。结果 B组VAS和VARS-5得分、僵痛和疲劳的发生率均低于A组和C组,A组亦低于C组(P<0.05);B组SF-16结果优于A组和C组,A组亦优于C组(P<0.05)。结论 BMI正常的纤维肌痛综合征妇女关节疼痛程度较低,疲劳发生率较低且生活质量较高。

  11. Mechanisms of Mitochondrial Defects in Gulf War Syndrome

    Science.gov (United States)

    2014-10-01

    GWS) is associated with increased incidences of amyotrophic lateral sclerosis, pain syndromes, muscle complaints that include fatigue and myalgias, as...expression in genes affecting mitochondrial function, and mtDNA mutations (inherited, somatic , and sporadic during embryogenesis). Gene expression...incidences of amyotrophic lateral sclerosis, pain syndromes, muscle complaints that include fatigue and myalgias, as well as other neurological symptoms

  12. Thermal fatigue of beryllium

    Energy Technology Data Exchange (ETDEWEB)

    Deksnis, E.; Ciric, D.; Falter, H. [JET Joint undertaking, Abingdon (United Kingdom)] [and others

    1995-09-01

    Thermal fatigue life of S65c beryllium castellated to a geometry 6 x 6 x (8-10)mm deep has been tested for steady heat fluxes of 3 MW/m{sup 2} to 5 MW/m{sup 2} and under pulsed heat fluxes (10-20 MW/m{sup 2}) for which the time averaged heat flux is 5 MW/m{sup 2}. These tests were carried out in the JET neutral beam test facility A test sequence with peak surface temperatures {le} 600{degrees}C produced no visible fatigue cracks. In the second series of tests, with T{sub max} {le} 750{degrees}C evidence for fatigue appeared after a minimum of 1350 stress cycles. These fatigue data are discussed in view of the observed lack of thermal fatigue in JET plasma operations with beryllium PFC. JET experience with S65b and S65c is reviewed; recent operations with {Phi} = 25 MW/m{sup 2} and sustained melting/resolidification are also presented. The need for a failure criterion for finite element analyses of Be PFC lifetimes is discussed.

  13. An update on the management of glandular fever (infectious mononucleosis and its sequelae caused by Epstein–Barr virus (HHV-4: new and emerging treatment strategies

    Directory of Open Access Journals (Sweden)

    A Martin Lerner

    2010-09-01

    Full Text Available A Martin Lerner1, Safedin H Beqaj2, Ken Gill3, James Edington3, James T Fitzgerald4, Robert G Deeter51Department of Medicine, William Beaumont Hospital, Royal Oak, MI, USA; 2DCL Medical Laboratories, Indianapolis, IN, USA; 3The Dr A Martin Lerner, Chronic Fatigue Syndrome Foundation, Beverly Hills, MI, USA; 4Department of Medical Education, University of Michigan, Medical School, Ann Arbor, MI, USA; 5Hematology-Oncology, Global Health Economics, Amgen Inc, Thousand Oaks, CA, USAPurpose: Beginning in 1993 at a single chronic fatigue syndrome (CFS treatment center, we began studies that demonstrate Epstein–Barr virus (EBV nonpermissive replication. In the most recent study performed, EBV nonpermissive replication is the cause of 28.3% of 106 consecutive CFS cases, and is etiologic with human cytomegalovirus (HCMV and/or human herpes virus 6 (HHV-6 as a coinfection in an additional 52.8% of CFS cases. Therefore, EBV is causally involved in 81% of cases of CFS. Further, EBV CFS is effectively treated with long-term valacyclovir. Coinfection HCMV and HHV-6 CFS requires valganciclovir with valacyclovir.Patients and results: The validated Energy Index Point Score® (EIPS® monitors severity of CFS illness and its recovery. A specific CFS diagnostic panel identifies EBV CFS subsets. Four separate EBV CFS therapeutic studies of several hundred CFS patients describe valacyclovir administration and long-term patient recovery. With valacyclovir, serum EBV titers (EBV, early antigen (diffuse; EBV, viral capsid antigen, immunoglobulin M; 24-hour electrocardiography Holter monitors; and cardiac dynamic studies improve.Conclusion: Nonpermissive EBV infection is causal in a significant proportion of CFS cases. EBV CFS is safely and effectively treated with long-term valacyclovir.Keywords: valacyclovir treatment, chronic fatigue syndrome, Epstein–Barr virus, EIPS, Energy Index Point Score

  14. Fatigue life prediction in composites

    CSIR Research Space (South Africa)

    Huston, RJ

    1994-01-01

    Full Text Available as the modulus is measured accurately. Its main disadvantage is that it can be applied only to constant amplitude fatigue loadings. REFERENCES 1. Mandell, J. F., Huang, D. D. & McGarry, F. J., Tensile fatigue performance...

  15. Fatigue design 1998

    Energy Technology Data Exchange (ETDEWEB)

    Marquis, G.; Solin, J. [eds.] [VTT Manufacturing Technology, Espoo (Finland)

    1998-12-31

    These preprints contain the presentations to be delivered at the Fatigue Design 1998 symposium held on May 26-29, 1998 in Espoo. Fatigue Design 1998 is the tenth in a series of VTT symposia addressing the challenge of fatigue of materials, components and structures. Previous international events were in 1992 and 1995. The key theme of the current meeting is `RELIABILITY`. The two volumes (VTT symposium 181-182) represent 56 contributions by authors representing 26 countries. Emphasis has been given to application oriented research topics that report new technologies, new uses of existing methods and case studies. The objective of the symposium is to bring together researchers and engineers to share experiences and new innovations in designing reliable components to resist alternating loads. (orig.)

  16. Moving stimuli are less effectively masked using traditional continuous flash suppression (CFS) compared to a moving Mondrian mask (MMM): a test case for feature-selective suppression and retinotopic adaptation.

    Science.gov (United States)

    Moors, Pieter; Wagemans, Johan; de-Wit, Lee

    2014-01-01

    Continuous flash suppression (CFS) is a powerful interocular suppression technique, which is often described as an effective means to reliably suppress stimuli from visual awareness. Suppression through CFS has been assumed to depend upon a reduction in (retinotopically specific) neural adaptation caused by the continual updating of the contents of the visual input to one eye. In this study, we started from the observation that suppressing a moving stimulus through CFS appeared to be more effective when using a mask that was actually more prone to retinotopically specific neural adaptation, but in which the properties of the mask were more similar to those of the to-be-suppressed stimulus. In two experiments, we find that using a moving Mondrian mask (i.e., one that includes motion) is more effective in suppressing a moving stimulus than a regular CFS mask. The observed pattern of results cannot be explained by a simple simulation that computes the degree of retinotopically specific neural adaptation over time, suggesting that this kind of neural adaptation does not play a large role in predicting the differences between conditions in this context. We also find some evidence consistent with the idea that the most effective CFS mask is the one that matches the properties (speed) of the suppressed stimulus. These results question the general importance of retinotopically specific neural adaptation in CFS, and potentially help to explain an implicit trend in the literature to adapt one's CFS mask to match one's to-be-suppressed stimuli. Finally, the results should help to guide the methodological development of future research where continuous suppression of moving stimuli is desired.

  17. Fatigue in primary biliary cirrhosis

    OpenAIRE

    Cauch-Dudek, K; Abbey, S; Stewart, D; Heathcote, E

    1998-01-01

    Background—Fatigue is a frequent and debilitating symptom in patients with primary biliary cirrhosis (PBC). 
Aims—To study fatigue in relation to sleep, depression, and liver disease severity. 
Methods—Patients with PBC completed validated self report questionnaires measuring fatigue, sleep quality, depression, and functional capacity. Verbally reported fatigue and observer rated measure of depression and ursodeoxycholic acid (UDCA) use were recorded. Liver biochemistry and ...

  18. Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Treatment

    Science.gov (United States)

    ... is having a good day and tries to push to do more than they would normally attempt (do too much, crash, rest, start to feel a little better, do too much once again). Strategies that do not involve use of medications and ...

  19. Reconstructing and modelling 71 years of forest growth in a Canadian boreal landscape : a test of the CBM-CFS3 carbon accounting model

    Energy Technology Data Exchange (ETDEWEB)

    Bernier, P.Y.; Guindon, L. [Canadian Forest Service, Quebec, PQ (Canada). Laurentian Forestry Centre; Kurz, W.A.; Stinson, G. [Canadian Forest Service, Victoria, BC (Canada). Pacific Forestry Centre

    2010-01-15

    Modelled estimates have suggested that Canada's managed forests are now shifting from being carbon sinks to becoming carbon sources. This study evaluated the Canadian Forest Sector carbon budget model (CBM-CFS3). A reconstructed dataset of forest growth and disturbances encompassing a 62 km{sup 2} landscape spanning a 71 year period were used to demonstrate that the CBM-CFS3 simulations underestimated realized net biomass accrual by 10 per cent in undisturbed stands, and may also underestimate biomass accrual in disturbed stands. Results from the model were compared with mechanistic model predictions, flux-tower measurements of ecosystem carbon exchanges, and long-term observations of changes in biomass. The errors were attributed to the initial 1928 operational forest photointerpretation and inventory procedures used to determine merchantable volume and biomass. Regionally parameterized yield curves may also be contributing to errors. Results of the study suggested that long-term trends in climate or atmospheric composition may not have contributed to the bias. A similar exercise conducted in a Pacific coastal forest demonstrated a small relative impact on total carbon from forest management activities in the absence of natural disturbances. 30 refs., 1 tab., 8 figs.

  20. Fatigue approach for addressing environmental effects in fatigue usage calculation

    Energy Technology Data Exchange (ETDEWEB)

    Wilhelm, Paul; Rudolph, Juergen [AREVA GmbH, Erlangen (Germany); Steinmann, Paul [Erlangen-Nuremberg Univ., erlangen (Germany). Chair of Applied Mechanics

    2015-04-15

    Laboratory tests consider simple trapezoidal, triangle, and sinusoidal signals. However, actual plant components are characterized by complex loading patterns and periods of holds. Fatigue tests in water environment show, that the damage from a realistic strain variation or the presence of hold-times within cyclic loading results in an environmental reduction factor (Fen) only half that of a simple waveform. This study proposes a new fatigue approach for addressing environmental effects in fatigue usage calculation for class 1 boiler and pressure vessel reactor components. The currently accepted method of fatigue assessment has been used as a base model and all cycles, which have been comparable with realistic fatigue tests, have been excluded from the code-based fatigue calculation and evaluated directly with the test data. The results presented show that the engineering approach can successfully be integrated in the code-based fatigue assessment. The cumulative usage factor can be reduced considerably.

  1. Caffeine, fatigue, and cognition

    NARCIS (Netherlands)

    Lorist, M.M.; Tops, M.

    2003-01-01

    Effects of caffeine and fatigue are discussed with special attention to adenosine-dopamine interactions. Effects of caffeine on human cognition are diverse. Behavioural measurements indicate a general improvement in the efficiency of information processing after caffeine, while the EEG data support

  2. FATIGUE OF DENTAL CERAMICS

    Science.gov (United States)

    Zhang, Yu; Sailer, Irena; Lawn, Brian R

    2013-01-01

    Objectives Clinical data on survival rates reveal that all-ceramic dental prostheses are susceptible to fracture from repetitive occlusal loading. The objective of this review is to examine the underlying mechanisms of fatigue in current and future dental ceramics. Data/sources The nature of various fatigue modes is elucidated using fracture test data on ceramic layer specimens from the dental and biomechanics literature. Conclusions Failure modes can change over a lifetime, depending on restoration geometry, loading conditions and material properties. Modes that operate in single-cycle loading may be dominated by alternative modes in multi-cycle loading. While post-mortem examination of failed prostheses can determine the sources of certain fractures, the evolution of these fractures en route to failure remains poorly understood. Whereas it is commonly held that loss of load-bearing capacity of dental ceramics in repetitive loading is attributable to chemically-assisted 'slow crack growth' in the presence of water, we demonstrate the existence of more deleterious fatigue mechanisms, mechanical rather than chemical in nature. Neglecting to account for mechanical fatigue can lead to gross overestimates in predicted survival rates. Clinical significance Strategies for prolonging the clinical lifetimes of ceramic restorations are proposed based on a crack-containment philosophy. PMID:24135295

  3. Incompatibility and Mental Fatigue

    Science.gov (United States)

    Herzog, Thomas R.; Hayes, Lauren J.; Applin, Rebecca C.; Weatherly, Anna M.

    2011-01-01

    A straightforward prediction from attention restoration theory is that the level of incompatibility in a person's life should be positively correlated with that person's level of mental (or directed attention) fatigue. The authors tested this prediction by developing a new self-report measure of incompatibility in which they attempted to isolate…

  4. Caffeine, fatigue, and cognition

    NARCIS (Netherlands)

    Lorist, M.M.; Tops, M.

    2003-01-01

    Effects of caffeine and fatigue are discussed with special attention to adenosine-dopamine interactions. Effects of caffeine on human cognition are diverse. Behavioural measurements indicate a general improvement in the efficiency of information processing after caffeine, while the EEG data support

  5. Fatigue of dental ceramics.

    Science.gov (United States)

    Zhang, Yu; Sailer, Irena; Lawn, Brian R

    2013-12-01

    Clinical data on survival rates reveal that all-ceramic dental prostheses are susceptible to fracture from repetitive occlusal loading. The objective of this review is to examine the underlying mechanisms of fatigue in current and future dental ceramics. The nature of various fatigue modes is elucidated using fracture test data on ceramic layer specimens from the dental and biomechanics literature. Failure modes can change over a lifetime, depending on restoration geometry, loading conditions and material properties. Modes that operate in single-cycle loading may be dominated by alternative modes in multi-cycle loading. While post-mortem examination of failed prostheses can determine the sources of certain fractures, the evolution of these fractures en route to failure remains poorly understood. Whereas it is commonly held that loss of load-bearing capacity of dental ceramics in repetitive loading is attributable to chemically assisted 'slow crack growth' in the presence of water, we demonstrate the existence of more deleterious fatigue mechanisms, mechanical rather than chemical in nature. Neglecting to account for mechanical fatigue can lead to gross overestimates in predicted survival rates. Strategies for prolonging the clinical lifetimes of ceramic restorations are proposed based on a crack-containment philosophy. Copyright © 2013 Elsevier Ltd. All rights reserved.

  6. Cumulative fatigue damage models

    Science.gov (United States)

    Mcgaw, Michael A.

    1988-01-01

    The problem of calculating expected component life under fatigue loading conditions is complicated by the fact that component loading histories contain, in many cases, cyclic loads of widely varying amplitudes. In such a case a cumulative damage model is required, in addition to a fatigue damage criterion, or life relationship, in order to compute the expected fatigue life. The traditional cumulative damage model used in design is the linear damage rule. This model, while being simple to use, can yield grossly unconservative results under certain loading conditions. Research at the NASA Lewis Research Center has led to the development of a nonlinear cumulative damage model, named the double damage curve approach (DDCA), that has greatly improved predictive capability. This model, which considers the life (or loading) level dependence of damage evolution, was applied successfully to two polycrystalline materials, 316 stainless steel and Haynes 188. The cumulative fatigue behavior of the PWA 1480 single-crystal material is currently being measured to determine the applicability of the DDCA for this material.

  7. Fatigue modelling for gas nitriding

    Directory of Open Access Journals (Sweden)

    H. Weil

    2016-10-01

    Full Text Available The present study aims to develop an algorithm able to predict the fatigue lifetime of nitrided steels. Linear multi-axial fatigue criteria are used to take into account the gradients of mechanical properties provided by the nitriding process. Simulations on rotating bending fatigue specimens are made in order to test the nitrided surfaces. The fatigue model is applied to the cyclic loading of a gear from a simulation using the finite element software Ansys. Results show the positive contributions of nitriding on the fatigue strength

  8. Muscle Deoxygenation Causes Muscle Fatigue

    Science.gov (United States)

    Murthy, G.; Hargens, A. R.; Lehman, S.; Rempel, D.

    1999-01-01

    Muscle fatigue is a common musculoskeletal disorder in the work place, and may be a harbinger for more disabling cumulative trauma disorders. Although the cause of fatigue is multifactorial, reduced blood flow and muscle oxygenation may be the primary factor in causing muscle fatigue during low intensity muscle exertion. Muscle fatigue is defined as a reduction in muscle force production, and also occurs among astronauts who are subjected to postural constraints while performing lengthy, repetitive tasks. The objectives of this research are to: 1) develop an objective tool to study the role of decreased muscle oxygenation on muscle force production, and 2) to evaluate muscle fatigue during prolonged glovebox work.