Presence Of Chronic Fatigue Syndrome Research Articles

Effect of Central Sensitization in Patients with Familial Mediterranean Fever, Axial Spondyloarthritis, and Both Diseases.

Our aim in this study was to evaluate the level of central sensitization (CS) in patients having familial Mediterranean fever (FMF), axial spondyloarthritis (axSpA), and both diseases (axSpA/FMF). This study included 30 FMF, 30 axSpA, 30 axSpA/FMF patients, and 30 healthy controls (HCs). The presence of CS was investigated by the Central Sensitization Inventory (CSI) questionnaire. In order to evaluate the effect of CS on patient groups, clinical features, disease activity, quality of life, sleep quality, depression, and anxiety frequency were examined. The patients were divided into groups according to the presence and severity of CS and their results were compared. The mean age of all participants was 28.4±5.7 years and 67 (55.8%) of them were male. The erythrocyte sedimentation rate (ESR) value was significantly higher in axSpA and axSpA/FMF groups than in FMF and HCs groups (p<0.001). ESR value was significantly higher in the FMF group than in the HCs group (p<0.001). C-reactive protein (CRP) value was significantly higher in the axSpA/FMF group than in the axSpA and HCs groups (p=0.001). CSI-Part A value was significantly higher in the axSpA, FMF, and axSpA/FMF group than in the HCs group (p<0.001). CSI-Part A value did not differ significantly between axSpA/FMF, axSpA, and FMF groups (p>0.05). The presence of chronic fatigue syndrome was found to be significantly higher in the FMF group than in the axSpA and HCs groups (p<0.05). Fibromyalgia syndrome was significantly higher in the axSpA/FMF group than in the axSpA, FMF, and HCs groups (p<0.05). In this study, the CS score was found to be significantly higher in axSpA and FMF patients compared to the HCs group. There was no difference between the disease groups in terms of CS score.

The duration of work-related fatigue as a criterion for assessing the workload and the cause of chronic diseases of workers

Introduction. The developers of fatigue risk management systems in the workplace note that there is no universal definition and a consistent way to measure workload, and that scientists have not sufficiently studied the relationship between workload and fatigue. The study aims to analyze the impact of the workload, estimated by the duration of the state of production-related fatigue of workers, on their subjective health and the risk of chronic diseases. Materials and methods. The study involved employees in three areas of employment: healthcare (697 employees), industry (751), education (687). Experts have determined four indicators of the risk of violation of the subjective health of employees during the year: the presence of chronic fatigue syndrome (Rcfs), deterioration of employee health during the year (Rdh), long-term illnesses during the year (Rli), fatigue accumulation during the year (Rfa). We have analyzed the diseases detected during periodic medical examination. The researchers have calculated the HFweek indicator - the duration of the fatigue state - "hours of fatigue per working week": HFweek (hour) = PRN (hour) × Kdf × Kff, where: PRN (hour) is the actual duration of the working week; Kdf and Kff are coefficients that take into account the degree and frequency of fatigue. We also have calculated the relative risk (RR). Results. The researchers have found that with more than 25 hours per week in 108 sample groups of workers in 25 cases, RR exceeded the control level by more than 5 times; in 44 comparison groups by 2.1-5 times and in 35 groups by 1.1-2.0 times. With a HFweek of more than 25 hours, there is an annual accumulation of fatigue (Rfa), similar in workers of all spheres of employment. At HFweek&gt;15 hours, the RR of chronic diseases of the musculoskeletal, respiratory, nervous systems and skin was in the range of 1.31-1.83. The RR of diseases of the genitourinary system (women) and endocrine system increased by 1.13 times; diseases of hypertension, diseases of the digestive system, visual system RR÷1,05-1,07. Conclusion. The HFweek indicator is the physiological equivalent of the professional workload of employees in various fields of employment. With HFweek&gt;25 hours, there is a sharp increase in health risks.

Incidence of chronic Q fever and chronic fatigue syndrome: A 6 year follow-up of a large Q fever outbreak.

Acute Q fever is a generally self-limiting infection caused by the intracellular gram-negative bacterium Coxiella burnetii. For yet unknown reasons, a subset of patients develops chronic infection. Furthermore, chronic fatigue syndrome (CFS) as post-acute Q fever sequelae has been described. We here investigated the rates of chronic Q fever and incidences of CFS 6 years after one of the largest European Q fever outbreaks that occurred in Jena, Germany in 2005 with 331 reported cases, who lived in proximity of a grazing flock of sheep. A total of 80 patients and their 52 non-diseased household members from the former outbreak, were enrolled 6 years after the outbreak. Blood samples were collected and tested for chronic Q fever which was determined by seroprevalence using referenced immunofluorescence assays. Also, the presence of CFS was assessed using the Short Form Symptom Inventory developed by the Centers (United States) for Disease Control and Prevention (SF CDC- SI). In 80 out of 132 (60.6%) study participants, previous Q fever infection was confirmed serologically, while no previous infection was detected in the 52 household members. None of the participants fulfilled the serological criteria of chronic Q fever. The evaluation of the CDC-SI did not show any differences between the two groups. Also, there was no difference between both groups regarding fulfillment of CFS-defining criteria (n = 3 (3.8%; sero-positive) versus n = 2 (3.8%; sero-negative), p = 0.655). Our 6-year follow-up study of a large Q fever outbreak did not find evidence of chronic Q fever or post Q fever CFS. There was no asymptomatic sero-positivity in household members of Q fever patients.

Increased intracranial pressure in migraine? Neuroimaging study on a cohort of migraineurs

Aim: To investigate the frequency of papilledema and radiological signs of increased intracranial pressure (ICP) in our cohort of migraineurs, and investigate the possible clinical predictors.Material and Methods: This was a cross-sectional study in which we have included all the patients with migraine who applied to our neurology clinic during January 2020 and accepted to involve in the study. The demographic and clinical characteristics including migraine subtype (episodic/chronic), headache frequency per month, headache characteristics were evaluated in all the study group. Besides, the presence of chronic fatigue syndrome (CFS) was noted. The fundus examination was performed in all the patients. Previously defined eight findings of increased ICP were evaluated by our radiologist. We have classified the migraineurs into two groups as migraineurs with clinical suspicion of increased ICP and those without. We have identified the patients with papilledema and/or positivity of at least one of the neuroimaging signs of increased ICP as migraineurs with suspicion of increased ICP. The remaining patients were defined as migraineurs without suspicion of increased ICP. Results: Ultimately, 63 migraineurs were included in this study. The median age was 36.8 ± 11.3 and the F/M ratio was 51/12. Papilledema was determined in 11 (17.4%) of the patients and 19 (30.1%) of the migraineurs had at least one of the neuroimaging signs of increased ICP. Twenty-six (41.3%) of the overall group were evaluated as migraineurs with suspicion of increased ICP and 37 of the patients were those without suspicion of increased ICP. The comparisons between these two patient groups revealed that obesity was more prevalent in the migraineurs with suspicion of increased ICP. Logistic regression analyses revealed obesity (OR: 0.090, P = 0.014) and radicular pain (OR: 7,647, P = 0.030) as clinical predictor factors for the patients with suspicion of increased ICP. Conclusion: We determined a high rate of patients with either a positive neuroimaging sign of increased ICP and/or papilledema in our cohort of migraineurs. Our results may suggest obesity and radicular as potential risk factors in the prediction of increased ICP in migraineurs. The results of this study need to be confirmed in future prospective-studies with the evaluations of the lumbar puncture opening pressures in the patient subgroup with required indication.

Specific and number of comorbidities are associated with increased levels of temporomandibular pain intensity and duration

BackgroundTemporomandibular pain disorder (TMD) is a common pain condition in the face. People with TMD report multiple pain comorbidities. The presence of fibromyalgia and migraine in people with TMD is associated with an increase in TMD pain intensity and duration. However, data on the relationship between increasing number of pain comorbidities and TMD pain are rare. The aims of this study were: firstly to evaluate the extent to which increasing number of comorbidities is associated with increasing TMD pain intensity and duration; and secondly to evaluate the extent to which the presence of specific comorbidities is associated with increasing TMD pain intensity and duration.MethodsThe sample included 180 people seeking TMD treatment at Boston and Montreal clinics. TMD was diagnosed using the Research Diagnostic Criteria for TMD. A Numerical Pain Rating Scale assessed TMD pain intensity and participants provided their TMD pain duration in a study questionnaire. The comorbidities of migraine, chronic fatigue syndrome, irritable bowel syndrome, interstitial cystitis and restless leg syndrome were diagnosed by 5 validated diagnostic questionnaires. The associations were analyzed by linear regression, controlling for confounders.ResultsThere was a positive association between the number of comorbidities present and TMD pain intensity (p < 0.01) and between the number of comorbidities present and TMD pain duration (p < 0.01). Also, the presence of migraine was positively associated with TMD pain intensity (p < 0.01) and the presence of chronic fatigue syndrome was positively associated with TMD pain intensity (p < 0.05) and with TMD pain duration (p < 0.01). When TMD patients were separated into groups, these associations did not change for the myofascial pain group, whereas in the non-myofascial pain group, the relationship between number of comorbidities and TMD pain duration was the only one still present.ConclusionThis study shows that the number of comorbidities is positively associated with TMD pain duration and intensity. The presence of specific conditions, such as migraine and chronic fatigue syndrome, is associated with an increase in TMD intensity and duration.

Aluminium overload after 5 years in skin biopsy following post-vaccination with subcutaneous pseudolymphoma

Aluminium hydroxide is used as an effective adjuvant in a wide range of vaccines for enhancing immune response to the antigen. The pathogenic role of aluminium hydroxide is now recognized by the presence of chronic fatigue syndrome, macrophagic myofasciitis and subcutaneous pseudolymphoma, linked to intramuscular injection of aluminium hydroxide-containing vaccines. The aim of this study is to verify if the subcutaneous pseudolymphoma observed in this patient in the site of vaccine injection is linked to an aluminium overload. Many years after vaccination, a subcutaneous nodule was discovered in a 45-year-old woman with subcutaneous pseudolymphoma. In skin biopsy at the injection site for vaccines, aluminium (Al) deposits are assessed by Morin stain and quantification of Al is performed by Zeeman Electrothermal Atomic Absorption Spectrophotometry. Morin stain shows Al deposits in the macrophages, and Al assays (in μg/g, dry weight) were 768.10±18 for the patient compared with the two control patients, 5.61±0.59 and 9.13±0.057. Given the pathology of this patient and the high Al concentration in skin biopsy, the authors wish to draw attention when using the Al salts known to be particularly effective as adjuvants in single or repeated vaccinations. The possible release of Al may induce other pathologies ascribed to the well-known toxicity of this metal.

When a Parent Is Chronically Ill

Chronic illness may reshape not only the life of the ill parent but also that of the entire family, but research in this area remains limited. More specifically, little is known about how an ill parent and the family respond to a particularly devastating and controversial chronic illness, chronic fatigue syndrome (CFS). The objective of this study was to describe the responses of the parent and the ensuing family system responses to the presence of chronic fatigue syndrome as a chronic parental illness. Parents were interviewed individually, and then the ill parent and as many immediate family members as possible were interviewed collectively. After consent or assent, interviews were audiotaped and transcribed. Thematic analyses at the individual, intrafamily, and across-family levels were used to explore these phenomena. Eight ill parents first described the onset of illness, an ongoing struggle to receive diagnosis and care, and the significance of the illness in transforming present and future roles. Multiple members of the family together with the ill parent described how they struggled with the reality of the illness, the shifting roles and responsibilities, the reduced family income, and the frequent social isolation that could be exacerbated by the controversial nature of the illness. Families described and demonstrated their struggles to maintain normal family life and plans in the face of continuing uncertainty. This study is situated within current scholarship on family responses to chronic parental illness. The value of the family research interview is affirmed. Recommendations are made for future directions in family nursing research exploring responses of families in which a parent is chronically ill.

Presence of chronic fatigue syndrome in endometriosis is associated with increased psychological stress and reduced cortisol levels

OBJECTIVE: The etiology of endometriosis and its different manifestations are poorly understood. Endometriosis is associated with chronic fatigue syndrome (CFS). Stressful experiences during times of heightened neural plasticity are suggested to persistently program neural, endocrine and immune responses leading to pain syndromes such as CFS. In this study, we compared salivary cortisol at awakening, stressful life events, and history of trauma in women with endometriosis with or without a diagnosis of CFS. DESIGN: We analyzed data from a population-based surveillance study of CFS in Wichita, Kansas, which included a two-day clinical evaluation of subjects with CFS and age- and race-matched controls. MATERIALS AND METHODS: Endometriosis was self-reported as part of a gynecological questionnaire. CFS diagnosis was ascertained using the CDC 1994 criteria. Childhood and adult stress were assessed using self-report questionnaires. Saliva cortisol samples, collected during clinic day 1, were analyzed using radioimmunoassay. RESULTS: Of 116 women (n = 58 CFS, n = 58 controls) who attended the clinic, 30 self-reported endometriosis (19 with and 11 without CFS). Endometriosis alone was not associated with any stress-related measures. However, compared to women with endometriosis only, women with both endometriosis and CFS reported significantly higher childhood (emotional neglect, P < 0.05 and adult perceived stress (P < 0.01), more negatively evaluated events (P < 0.05), higher depressivity scores (P < 0.01), and slightly lower awakening cortisol concentrations (not sign.). CONCLUSIONS: Endometriosis alone was not associated with any stress-related measures. However, women with endometriosis and CFS had a higher rate of childhood and adult stress compared to women with a diagnosis of endometriosis only. Cortisol awakening response was marginally lower in women with endometriosis and CFS. The clinical relevance of these findings will be discussed.

Symptoms of autonomic dysfunction in chronic fatigue syndrome

Chronic fatigue syndrome (CFS) is common and its cause is unknown. To study the prevalence of autonomic dysfunction in CFS, and to develop diagnostic criteria. Cross-sectional study with independent derivation and validation phases. Symptoms of autonomic dysfunction were assessed using the Composite Autonomic Symptom Scale (COMPASS). Fatigue was assessed using the Fatigue Impact Scale (FIS). Subjects were studied in two groups: phase 1 (derivation phase), 40 CFS patients and 40 age- and sex-matched controls; phase 2 (validation phase), 30 CFS patients, 37 normal controls and 60 patients with primary biliary cirrhosis. Symptoms of autonomic dysfunction were strongly and reproducibly associated with the presence of CFS or primary biliary cirrhosis (PBC), and correlated with severity of fatigue. Total COMPASS score >32.5 was identified in phase 1 as a diagnostic criterion for autonomic dysfunction in CFS patients, and was shown in phase 2 to have a positive predictive value of 0.96 (95%CI 0.86-0.99) and a negative predictive value of 0.84 (0.70-0.93) for the diagnosis of CFS. Autonomic dysfunction is strongly associated with fatigue in some, but not all, CFS and PBC patients. We postulate the existence of a 'cross-cutting' aetiological process of dysautonomia-associated fatigue (DAF). COMPASS >32.5 is a valid diagnostic criterion for autonomic dysfunction in CFS and PBC, and can be used to identify patients for targeted intervention studies.

Mirrored Symptoms in Mother and Child With Chronic Fatigue Syndrome

Our aim with this study was to assess the relation between chronic fatigue syndrome in adolescents and fatigue and associated symptoms in their fathers and mothers, more specifically the presence of chronic fatigue syndrome-like symptoms and psychologic distress. In this cross-sectional study, 40 adolescents with chronic fatigue syndrome according to the Centers for Disease Control and Prevention criteria were compared with 36 healthy control subjects and their respective parents. Questionnaires regarding fatigue (Checklist Individual Strength), fatigue-associated symptoms, and psychopathology (Symptom Checklist-90) were applied to the children and their parents. Psychologic distress in the mother corresponds with an adjusted odds ratio of 5.6 for the presence of CFS in the child. The presence of fatigue in the mother and dimensional assessment of fatigue with the Checklist Individual Strength revealed odds ratios of, respectively, 5.29 and 2.86 for the presence of chronic fatigue syndrome in the child. An increase of 1 SD of the hours spent by the working mother outside the home reduced the risk for chronic fatigue syndrome in their child with 61%. The fathers did not show any risk indicator for chronic fatigue syndrome in their child. Mothers of adolescents with chronic fatigue syndrome exhibit fatigue and psychologic symptoms similar to their child in contrast with the fathers. The striking difference between the absent association in fathers and the evident association in mothers suggests that the shared symptom complex of mother and child is the result of an interplay between genetic vulnerability and environmental factors.

Combinations of Single Nucleotide Polymorphisms in Neuroendocrine Effector and Receptor Genes Predict Chronic Fatigue Syndrome

This paper asks whether the presence of chronic fatigue syndrome (CFS) can be more accurately predicted from single nucleotide polymorphism (SNP) profiles than would occur by chance. Specifically, given SNP profiles for 43 CFS patients, together with 58 controls, we used an enumerative search to identify an ensemble of conjunctive rules that predict whether a patient has CFS. The accuracy of the rules reached 76.3%, with the highest accuracy rules yielding 49 true negatives, 15 false negatives, 28 true positives and nine false positives (odds ratio [OR] 8.94, p < 0.0001). Analysis of the SNPs used most frequently in the overall ensemble of rules gave rise to a list of 'most important SNPs', which was not identical to the list of 'most differentiating SNPs' that one would calculate via studying each SNP independently. The top three genes containing the SNPs accounting for the highest accumulated importances were neuronal tryptophan hydroxylase (TPH2), catechol-O-methyltransferase (COMT) and nuclear receptor subfamily 3, group C, member 1 glucocorticoid receptor (NR3C1). The fact that only 28 out of several million possible SNPs predict whether a person has CFS with 76% accuracy indicates that CFS has a genetic component that may help to explain some aspects of the illness.

Contribution à l’étude clinique et psychopathologique du syndrome de fatigue chronique

The diagnosis of chronic fatigue syndrome is illustrated with case studies and the condition is reconsidered with special emphasis on psychopathology. According to the author, the presence in these cases of a neurotic disorder sets the indication for a psychotherapy with psychodynamic or existential approach. Considering the frequent presence of chronic fatigue syndrome in ambulatory care settings and the risk of an evolution into a seriously handicapping condition, the importance of correct diagnosis and psychotherapeutic treatment is underlined.

Cardiac Involvement in Patients with Chronic Fatigue Syndrome as Documented with Holter and Biopsy Data in Birmingham, Michigan, 1991-1993

We report the prevalence of abnormal oscillating T-waves at Holter monitoring in a consecutive case series of 67 chronic fatigue syndrome (CFS) patients from an infectious diseases center in Birmingham, Michigan, in the years 1991-1993 , and compare these abnormal T-waves to similar tests in 78 non-CFS patients matched for age, place, time, and the absence of known other confounding medical diseases. Patients in both groups had normal resting 12-lead electrocardiograms (ECGs), rest/stress myocardial perfusion studies (thallium 201 or TC-99 sestamibi studies and two-dimensional echocardiograms (except for the incidental findings of mitral valve prolapse without significant regurgitation or, an incidental nonsignificant aortic stenosis). The prevalence of labile Twave abnormalities by Holter monitoring was greater in CFS patients than in non-CFS patients (P<.01). Repetitive T-wave flattening was a sensitive indicator of the presence of CFS. The absence of these abnormal T-waves made the diagnosis of CFS unlikely (statistical sensitivity, 0.96). The combination (e.g., the presence of both oscillating Twave flattenings plus T-wave inversions) was an accurate indicator of the possible presence of CFS. Right ventricular endomyocardial biopsies in CFS patients showed a single patient with lymphocytic myocarditis. Light and electron microscopic cardiomyopathic changes were present in the others. Copywrite 1997 Williams & Wilkins