Chronic fatigue syndrome

Chronic fatigue syndrome is a controversial disease entity. Opinions range from non-disease via psychiatric disorder to a somatic disturbance. Somatic pathogenetic hypotheses include persisting infections, intoxications, metabolic or immunologic disturbances, nervous system diseases and endocrine pathology. None of these hypotheses has been substantiated as yet. Psychological factors are important in the course of the disorder and can be used in the therapeutic approach of patients with chronic fatigue syndrome.     

Chronic fatigue syndrome

A great concern is recently given to the chronic fatigue syndrome in the Czech Republic. Unfortunately, published data allow us to state neither the etiologic agent nor the pathophysiology of the disease. Although many authors published various laboratory abnormalities, these changes are inconstant and do not allow to state a diagnosis of the chronic fatigue syndrome by a single laboratory test, and effective therapy is not known either. Psychotherapy, and in some cases antidepressants, are recommended by some authors to alleviate patient's symptoms. Neither immunological nor antiviral therapy showed positive results in controlled trials and are not generally used in most centers.     

Chronic fatigue syndrome

In chronically instrumented, conscious rabbits at moderately warm ambient thermal conditions, infusion of the NO-donor SIN-1 into the anterio-ventral 3rd cerebral ventricle (1-2 microg/min per kg BW, 2-4 microl/min, 30 min) initiated a co-ordinated activation of autonomic heat loss mechanisms, as indicated by the rise in ear skin temperature and by increases in panting frequency and respiratory evaporative water loss, while oxygen consumption decreased slightly. The heat loss responses were similar to those attributed to NO in studies employing systemic application of NO-donors. Different from NO acting peripherally, which causes arterial hypotension and tachycardia, centrally acting NO induced arterial hypertension and bradycardia. The observation of the same heat loss responses despite opposing circulatory actions suggests that NO is specifically involved in thermoregulation as a central activator of heat defense mechanisms.     

Chronic fatigue syndrome

The hepatoprotective activity of crude extract of artemisia scoparia (aerial parts) was investigated against experimentally produced hepatic damage using carbon tetrachloride (CCl4) as a model hepatotoxin. CCl4 at the dose of 1.5 ml/kg, produced liver damage in rats as manifested by the rise in serum levels of AST and ALT to 395 +/- 110 and 258 +/- 61 IU/l (mean +/- SEM; n = 10) respectively, compared to control values of 106 +/- 15 and 26 +/- 04. Pretreatment of rats with plant extract (150 mg/kg) significantly lowered (P < 0.01), the respective serum GOT and GPT levels to 93 +/- 05 and 27 +/- 03 IU/l, indicating hepatoprotective action. Pentobarbital sodium (75 mg/kg)-induced sleeping time in mice was found to be 140.8 +/- 1.5 min (n = 10) which was similar (P > 0.05) to that obtained in the group of animals pretreated with the plant extract (139.9 +/- 1.8 min). CCl4 treatment extended the pentobarbital sleeping time to 212.2 +/- 19.1 min and pretreatment of animals with plant extract reversed the CCl4-induced prolongation in pentobarbital sleeping time to 143.9 +/- 5.5 min (P < 0.001) which further confirms the protective action of the plant extract against CCl4-induced liver damage. These data indicate that the plant artemisia scoparia is hepatoprotective and validate the folkloric use of this plant in liver damage.     

Chronic fatigue syndrome

Fatigue is one of the most common medical complaints. Sometimes, fatigue is chronic, unexplained and induces significant distress or impairment in social, occupational or other important areas of functioning. This condition was described as neurasthenia by Beard at the end of the 19th Century; more recently the United States Centers for Disease Control and Prevention (CDC) suggested to call it "Chronic Fatigue Syndrome" (SFC). Both are considered as physical diseases and share certain therapeutic measures. Pathophysiology is still unknown and may involve viral agents, immunological processes or psychiatric disorders. Similarly most of the treatments which have been properly evaluated seem to be more or less inefficacious.     

Chronic fatigue syndrome: physical and cardiovascular deconditioning

We investigated whether chronic fatigue syndrome (CFS) patients have physical and/or cardiovascular de-conditioning, in 273 CFS patients and 72 healthy controls. We used laboratory tests to assess haematological, biochemical, endocrinological and immunological systems. The cardiovascular system was assessed by echocardiography and carotid echography. Body composition was determined by dual energy X-ray absorptiometry (DEXA). CFS patients had smaller left ventricular end systolic (p < 0.001) and diastolic (p = 0.008) dimensions but thinner posterior walls (p = 0.02) than corresponding values in healthy controls. Left ventricular mass was also reduced in CFS patients (p = 0.006). Both maximum (p < 0.001) and minimum (p < 0.008) diameter of the carotid artery were smaller in CFS patients. The laboratory screening tests showed significant differences in serum albumin (p = 0.05), phosphate (p = 0.02), HDL-cholesterol (p = 0.03), HDL:total cholesterol ratio (p = 0.01), triglycerides (p = 0.02), neutrophils (p = 0.01) and thyroid-stimulating hormone (p = 0.04) between CFS patients and controls. Male CFS patients had an increased percentage of fat mass compared with healthy male subjects (p = 0.02). This large group of CFS patients had evidence of physical and cardiovascular de-conditioning, suggesting that in these patients a graded exercise programme could lead to physical reconditioning and could increase their ability to perform physical activities.     

Chronic fatigue syndrome: a novel disorder with cutaneous manifestations

Effects of heating and 60cobalt (60Co) irradiation to hepatitis C virus (HCV) RNA in sera were studied. HCV-RNA can not be detected by PCR in 10 positive serum samples after being heated at 56 degrees C for 10 hours. Whereas, HCV-RNA can still be detected in positive sera after being lyophilized and then heated at 60 degrees C for 20 hours. It suggested heating at 56 degrees C for 10 hours can inactivate HCV in sera and the sera should be in liquid status when thermal inactivation is taken. Lyophilized sera with thermal inactivation for HCV should be inactivated first and then lyophilized. But the safety of sera with heat-treatment should be further investigated. Inactivation of HCV in sera with 60Co irradiation needed extra large dose of it, and protein components in sera would obviously be altered. Therefore, inactivation of HCV in sera with 60Co irradiation is impractical.     

Chronic fatigue syndrome in young persons

The prevalence of chronic fatigue syndrome (CFS) in teenagers is 10-20 per 100,000 inhabitants in the Netherlands. The natural course of the disorder is not favourable according to the literature. Proposed criteria for the diagnosis 'CFS' in adolescence are: absence of a physical explanation for the complaints, a disabling fatigue for at least six months and prolonged school absenteeism or severe motor and social disabilities. Exclusion criterion should be a psychiatric disorder. Factors that attribute to the persistence of fatigue are somatic attributions, illness enhancing cognitions and behaviour of parents as well as physical inactivity. The role of the physician and the role of parents can enhance the problems. The treatment should focus on decreasing the somatic attributions, on reinforcement by the parents of healthy adolescent behaviour, on the gradual increase of physical activity and on decreasing attention (including medical attention) for the somatic complaints.     

Chronic fatigue syndrome: A new clinical application.

Chronic fatigue syndrome (CFS), a poorly understood illness of uncertain etiology, has received scant attention in the psychological literature. This article reviews the CFS research literature from a clinical perspective, presents explanatory models of the illness, and describes cognitive–behavioral interventions for CFS. Finally, case management issues that are based on the author's research and clinical observations are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Chronic fatigue syndrome, chronic fatigue, and psychiatric disorders: Predictors of functional status in a national nursing sample.

Members of 2 nurses' associations (N?=?71) were assessed using 2 mail questionnaires, a telephone questionnaire, the Diagnostic Interview Schedule, and medical records. Physicians reviewed participants to determine whether they met current criteria for chronic fatigue syndrome (CFS). Stepwise multivariate regression analyses were conducted to identify predictors of functional status scores. Impairments in physical, role, and social functioning increased as fatigue severity increased. Bodily pain increased as fatigue severity increased, and ratings of overall health increased as severity of fatigue decreased. Nurses with a current psychiatric diagnosis reported more impairments in emotional functioning than nurses with a lifetime diagnosis or no psychiatric diagnosis. Quality of life decreased as fatigue severity increased. Nurses with fatigue not meeting CFS criteria reported better quality of life than those with CFS or medical exclusions. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Chronic pancreatitis: a cause of cholestasis

The bile ducts were visualised using endoscopic retrograde cholangiopancreatography (ERCP), percutaneous or intravenous cholangiography in 38 patients with non-gallstone chronic pancreatitis. Stenosis of the intrapancreatic portion of the distal common bile duct was demonstrated in 11 patients. Ten of the 11 developed transient cholestasis during exacerbations of their chronic pancreatitis. In six cholestasis eventually persisted requiring surgical relief. Secondary biliary cirrhosis was present in one patient. No evidence of pancreatic carcinoma was found in the patients explored surgically. Ten of the patients are alive more than one year after diagnosis. Chronic pancreatitis was of alcoholic aetiology in 10 of the patients with biliary stenosis. Cholestasis and biliary stricture are common but poorly recognised complications of non-gallstone chronic pancreatitis, especially when pancreatitis is severe and due to alcohol.