2. RES: Abstract of article by Montoya et al  on valganciclovir, published in Journal of Clinical Virology, December 2006

    3. RES,NOTICE:  The Times reports on new US drug trial involving valganciclovir

    4. RES: Skin biopsy findings: Implications for the  pathophysiology of fibromyalgia

    5. RES: Efficacy of Farabloc as an analgesic in primary  fibromyalgia

    6. RES: Increased cancer risk in patients referred to hospital with suspected fibromyalgia

    7. RES: Musculoskeletal Pain in Malaysia: A COPCORD Survey

    8. MED: Medically Unexplained Physical Symptoms to be posted

        Date:    Tue, 9 Jan 2007 04:27:54 +0100
        From:    Jan van Roijen <j.van.roijen@xxxxx.xx>
        Subject: res: New therapy for CFS to be tested at Stanford

        ~:~:~:~:~:~:~:~:~:~:~:~

        ~:~:~:~:~:~:~:~:~:~:~:~
       >>> Help ME Circle <<<
       >>> 9 January 2007 <<<
        ~:~:~:~:~:~:~:~:~:~:~:~

        This is a primitive version of Help ME Circle;
        only sent to Co-Cure, because I lost all my addresses.

        ````
        I have 2 drives in my PC: one with all my data:
        my whole medical archive, all my programs with serial numbers,
        all my downloads, Eudora with all addresses, etc, etc,

        I use my second drive for back-up:
        every night with Norton Ghost and also DataKeeper, which
        stores a back-up with every change on my PC, because
        I'm very afraid to loose my data.

        Some weeks ago I had a PC crash and installed XP again.
        When I was finished I saw that my back-up drive was EMPTY !
        The cause: a confluence of events - too complicated to explain.

        Anyhow I'm really seized by panic.

        I'm emailing, phoning and googling for weeks.

        Most people assure me that the data can be find back
        with a `good recovery program.

        Yesterday I installed a demo version of a rather expensive
        recovery program - it is busy now for 24 hours and it will take
        another 24 hours till it has read the whole drive. Then I can see if
        I can find back, what I need.

        And to-day I'm very lucky, because a friend sent me the same
        program with a serial number as a present. I will install this
        program, when the demo is ready.

        Please keep your fingers crossed for me.


        ~jan


        ````````````````````

http://www.eurekalert.org/pub_releases/2007-01/sumc-ntf010807.php


        Public release date: 8-Jan-2007


        Contact: Louis Bergeron
    
louisb3@xxxxx.xxx
        650-723-0272
        Stanford University Medical Center


        New therapy for chronic fatigue syndrome to be tested at Stanford

        STANFORD, Calif. -- A preliminary study suggests
        there may be hope in the offing for some
        sufferers of chronic fatigue syndrome with a new
        therapy being tested by researchers at the
        Stanford University School of Medicine.

        Joseph Montoya, MD, associate professor of
    medicine
        (infectious diseases), and postdoctoral scholar
        Andreas Kogelnik, MD, PhD, have used the drug
        valganciclovir - an antiviral often used in
        treating diseases caused by human herpes viruses
        - to treat a small number of CFS patients.

        The researchers said they treated 25 patients
        during the last three years, 21 of whom responded
        with significant improvement that was sustained
        even after going off the medication at the end of
        the treatment regimen, which usually lasts six
        months. The first patient has now been off the
        drug for almost three years and has had no
        relapses. A paper describing the first dozen
        patients Montoya and Kogelnik treated with the
        drug was published in the December issue of Journal of Clinical Virology.

        "This study is small and preliminary, but
        potentially very important," said Anthony
        Komaroff, MD, professor of medicine at Harvard
        Medical School, who was not involved in the
        study. "If a randomized trial confirmed the value
        of this therapy for patients like the ones
        studied here, it would be an important landmark
        in the treatment of this illness."

        Montoya has received a $1.3 million grant from
        Roche Pharmaceutical, which manufactures the drug
        under the brand name Valcyte, to conduct a
        randomized, placebo-controlled, double-blind
        study set to begin this quarter at Stanford. The
        study will assess the effectiveness of the drug
        in treating a subset of CFS patients.

        Montoya is speaking about his efforts at the
        biannual meeting of the International Association
        for Chronic Fatigue Syndrome in Fort Lauderdale on Jan. 11 and 12.

        Chronic fatigue syndrome has baffled doctors and
        researchers for decades, because aside from
        debilitating fatigue, it lacks consistent
        symptoms. Although many genetic, infectious,
        psychiatric and environmental factors have been
        proposed as possible causes, none has been nailed
        down. It was often derided as "yuppie flu," since
        it seemed to occur frequently in young
        professionals, though the Centers for Disease
        Control and Prevention says it's most common in
        the middle-aged. But to those suffering from it,
        CFS is all too real and its effects are
        devastating, reducing once-vigorous individuals
        to the ranks of the bedridden, with an
        all-encompassing, painful and sleep-depriving fatigue.

        More than 1 million Americans suffer from the
        disorder, according to the CDC. The disease often
        begins with what appears to be routine flulike
        symptoms, but then fails to subside completely -
        resulting in chronic, waxing and waning debilitation for years.

        Valganciclovir is normally used against diseases
        caused by viruses in the herpes family, including
        cytomegalovirus, Epstein-Barr virus and human
        herpes virus-6. These diseases usually affect
        patients whose immune systems are severely
        weakened, such as transplant and cancer patients.
        Montoya, who had used the drug in treating such
        patients for years, decided to try using it on a
        CFS patient who came to him in early 2004 with
        extremely high levels of antibodies for three of
        the herpes family viruses in her blood. At the
        time, she had been suffering from CFS for five years.

        When a virus infects someone, the levels of
        antibodies cranked out by the immune system in
        response typically increase until the virus is
        overcome, then slowly diminish over time. But
        Montoya's patient had persistently high
        antibodies for the three viruses. In addition,
        the lymph nodes in her neck were significantly
        enlarged, some up to eight times their normal
        size, suggesting her immune system was fighting
        some kind of infection, even though a
        comprehensive evaluation had failed to point to any infectious cause.

        Concerned about the unusual elevations in
        antibody levels as well as the swelling of her
        lymph nodes, Montoya decided to prescribe
        valganciclovir. "I thought by giving an antiviral
        that was effective against herpes viruses for a
        relatively long period of time, perhaps we could
        impact somehow the inflammation that she had in her lymph nodes,"
    said
        Montoya.

        Within four weeks, the patient's lymph nodes
        began shrinking. Six weeks later she phoned
        Montoya from her home in South America,
        describing how she was now exercising, bicycling
        and going back to work at the company she ran
        before her illness. "We were really shocked by this," recalled Montoya.

        Of the two dozen patients Montoya and Kogelnik
        have since treated, the 20 that responded all had
        developed CFS after an initial flulike illness,
        while the non-responders had suffered no initial flu.

        Some of the patients take the drug for more than
        six months, such as Michael Manson, whose battle
        with CFS has lasted more than 18 years. The
        former triathlete was stricken with a viral
        infection a year after his marriage. After trying
        unsuccessfully to overcome what he thought were
        lingering effects of the flu, he had no choice
        but to drastically curtail all his activities and eventually stop working.

        During his longest period of extreme fatigue, 13
        1/2 weeks, Manson said, "My wife literally
        thought I was passing away. I could hear the
        emotion in her voice as she tried to wake me, but
        I couldn't wake up to console her. That was just maddening."

        Now in his seventh month of treatment, Manson is
        able to go backpacking with his children with no
        ill after-effects. Prior to starting the
        treatment, Manson's three children, ages 9 to 14, had never seen
    him
    healthy.

        Montoya and Kogelnik emphasized that even if
        their new clinical trial validates the use of
        valganciclovir in treating some CFS patients, the
        drug may not be effective in all cases. In fact,
        the trial will assess the effectiveness of the
        medication among a specific subset of CFS
        patients; namely, those who have viral-induced
        dysfunction of the central nervous system.

        "This could be a solution for a subset of
        patients, but that subset could be quite large,"
        said Kristin Loomis, executive director of the
        HHV-6 Foundation, which has helped fund a
        significant portion of the preparatory work for
        the clinical trial. "These viruses have been
        suspected in CFS for decades, but researchers
        couldn't prove it because they are so difficult
        to detect in the blood. If Montoya's results are
        confirmed, he will have made a real breakthrough."

        "What is desperately needed is the completion of
        the randomized, double-blind, placebo-controlled
        clinical trial that we are about to embark on," Montoya said.


        ###

        BROADCAST MEDIA CONTACT: M.A. Malone at (650) 723-6912

    (mamalone@xxxxx.xxx)

        People interested in participating in the
        clinical trial must live in the San Francisco Bay
        Area. More information about the clinical trial
        is available online at http://www.vicd.info/clinicaltrial.html.

        Stanford University Medical Center integrates
        research, medical education and patient care at
        its three institutions - Stanford University
        School of Medicine, Stanford Hospital & Clinics
        and Lucile Packard Children's Hospital at
        Stanford. For more information, please visit the
        Web site of the medical center's Office of
        Communication & Public Affairs at http://mednews.stanford.edu.


    [Return to top]

    ------------------------------

        Date:    Thu, 11 Jan 2007 01:26:41 +1100
        From:    ian <kanga20@xxxxx.xxx>
        Subject: RES: Abstract of article by Montoya et al  on valganciclovir, published in Journal of Clinical Virology, December 2006

        Use of valganciclovir in patients with elevated antibody titers against
        Human Herpesvirus-6 (HHV-6) and Epstein−Barr Virus (EBV)
        who were experiencing central nervous system dysfunction including
        long-standing fatigue

        Andreas M. Kogelnika, Kristin Loomisb, Mette Hoegh-Petersenc, Fernando
        Rosso a,c, Courtney Hischier b, Jose G. Montoya a,c, °
        a Stanford University School of Medicine, Stanford, CA, USA
        b HHV-6 Foundation, Santa Barbara, CA, USA
        c Palo Alto Medical Foundation Research Institute, Palo Alto, CA, USA

        Abstract

        Background: Twelve patients with long-standing symptoms of central
        nervous system (CNS) dysfunction were found to have elevated antibody
        titres to human herpesvirus-6 (HHV-6) and Epstein–Barr virus (EBV). All
        patients had four or more of the following neurocognitive symptoms:
        impaired cognitive functioning, slowed processing speed, sleep
        disturbance, short-term memory deficit, fatigue and symptoms consistent
        with depression.

        Objectives: We sought to determine whether elevated antibodies to EBV
        and HHV-6 indicated chronic viral activation in patients with CNS
        dysfunction and if their symptoms could be improved by suppressing viral
        activity with oral valganciclovir.

        Study design: Patients with high IgG antibody titers against HHV-6 and
        EBV who were suffering from central nervous system dysfunction and
        debilitating fatigue for more than one year (median 3 years, range 1−8
        years) were treated with 6 months of valganciclovir in an open label study.

        Results: Nine out of 12 (75%) patients experienced near resolution of
        their symptoms, allowing them all to return to the workforce or full
        time activites. In the nine patients with a symptomatic response to
        treatment, EBV VCA IgG titers dropped from 1:2560 to 1:640 ( p = 0.008)
        and HHV-6 IgG titers dropped from a median value of 1:1280 to 1:320 ( p
        = 0.271). Clinically significant hematological toxicity or serious
        adverse events were not observed among the 12 patients.

        Conclusion: These preliminary clinical and laboratory observations merit
        additional studies to establish whether this clinical response is
        mediated by an antiviral effect of the drug, indirectly via
        immunomodulation or by placebo effect.
        © 2006 Elsevier B.V. All rights reserved.

    [Return to top]

    ------------------------------

        Date:    Thu, 11 Jan 2007 17:07:16 -0500
        From:    "Dr. Charles Shepherd <charlesbshepherd@xxxxx.xxx> (via Co-Cure
Moderators)"
        Subject: RES,NOTICE:  The Times reports on new US drug trial involving valganciclovir

*MAY BE REPOSTED*
        **
        *'Drug to be tested on ME patients'*
        **
        *The Times - 11 January 2007*
        **
        *Web link:*
        **
http://www.timesonline.co.uk/article/0,,8122-2542213,00.html

        Dr Charles Shepherd
        Medical Adviser, ME Association

    [Return to top]

    ------------------------------

        Date:    Fri, 12 Jan 2007 15:10:24 -0500
        From:    "Bernice A. Melsky" <bernicemelsky@xxxxx.xxx>
        Subject: RES: Skin biopsy findings: Implications for the  pathophysiology of fibromyalgia

        Skin biopsy findings: Implications for the pathophysiology of fibromyalgia.

        Med Hypotheses. 2007 Jan 8; [Epub ahead of print]

        Kim SH.

        Department of Internal Medicine, Dongguk University College of Medicine,
        1090-1 Sukjang-dong, Gyeongju-si 780-714, Republic of Korea.

        PMID: 17215086


        The mechanisms responsible for symptom expression in fibromyalgia (FM) are
        complex. The most consistently detected objective abnormalities in FM
        involve pain-processing systems. Up to recently, central nervous system was
        a primary focus of investigations in FM. Although it is unlikely that FM
        occurs because of primary disorders of the peripheral tissues, there are
        still data to suggest that some abnormalities can be detected in the
        periphery. With the recognition of abnormalities in skin of some FM
        patients, it is now apparent that the role of peripheral nerve endings in
        FM is much greater than previously thought. The aim of this paper is to
        review literature concerning the skin biopsy findings of FM patients and
        discuss their potential relevance to FM.

        This paper suggests that patients with FM represent a state of the
        dysfunction of descending, antinociceptive pathways and low
        hypothalamic-pituitary-adrenal function. This state is further proposed to
        result in many skin biopsy findings associated with the disorder, including
        increased N-methyl-d-aspartate receptors subtype 2D expression, neurogenic
        inflammation and characteristic electron microscopic findings. Future
        direction of research would be identification of specific laboratory
        markers such as skin biopsy for diagnostic and clinical evaluation purposes
        in FM.

    [Return to top]

     ------------------------------

        Date:    Fri, 12 Jan 2007 15:13:50 -0500
        From:    "Bernice A. Melsky" <bernicemelsky@xxxxx.xxx>
        Subject: RES: Efficacy of Farabloc as an analgesic in primary  fibromyalgia

        Efficacy of Farabloc as an analgesic in primary fibromyalgia.

        Clin Rheumatol. 2007 Jan 11; [Epub ahead of print]

        Bach GL, Clement DB.

        Department of Medicine/Rheumatology, University of Munich, Munich, Germany.

        PMID: 17216399


        The goal of our study was to determine the efficacy of Farabloc, an
        electromagnetic shielding fabric compared to placebo fabric when worn as a
        nightgown, as an analgesic in patients hospitalized with fibromyalgia. In a
        rheumatologic and rehabilitation hospital, we performed a phase 1,
        single-blind study of patients using Farabloc (F) or placebo (P) gowns for
        8 h per night during the 20-day hospitalization and a phase 2, single-blind
        crossover study of patients using both F and P gowns randomly and
        alternatively switching after 10 of 21 days hospitalization (phase 1: 42 F,
        mean age 49.02 years, 35 female, 7 male; 84 P, mean age 48.08 years, 72
        female, 12 males; phase 2: 25 F/P, P/F, or P/P, mean age 44.0 years, 24
        female, 1 male). The study involved randomly selected and blinded use of
        hospital gown 8 h per night of either F or P fabric.

        The main outcome measures were changes from admission or midpoint to
        discharge in quantity of pain (QN), quality of pain (QL), and paracetamol
        use (PU). In phase 1, all three variables significantly favored F over P
        when using paired t test, two sample t test, Mann-Whitney, and analysis of
        covariance tests. QN was reduced (F = -2.03 -/+ 0.99*, P = 0.59 -/+ 0.71).
        QL was reduced (F = -10.64 -/+ 5.69*, P = -2.54 -/+ 3.40). PU was reduced
        (F = 10.69 -/+ 6.68*, P = 26.12 -/+ 9.37). In phase 2, comparing midpoint
        to discharge levels in the three variables again favored P/F over F/P and
        P/P (>0.001): QN (P/F +16.00 -/+ 8.35* F/P -13.27 -/+ 11.40), QL (P/F +8.71
        -/+ 4.75* F/P -6.55 -/+ 5.59), and PU (F -9.29 -/+ 4.39* P -18.00 -/+ 5.27)
        (*p = <0.001). Patients with fibromyalgia had less pain after sleeping in a
        gown made of Farabloc than with a placebo fabric.

        This suggests that Farabloc, an electromagnetic shielding fabric, has
        analgesic properties in fibromyalgia. Reduced pain observation is
        consistent with previous studies in phantom limb pain and delayed onset
        muscle pain. Limitations of this study include single blind design, small
        sample size, and in phase 2, a lack of washout period and a F/F group.

    [Return to top]

    ------------------------------

        Date:    Sat, 13 Jan 2007 13:45:55 -0500
        From:    "Bernice A. Melsky" <bernicemelsky@xxxxx.xxx>
        Subject: RES: Increased cancer risk in patients referred to hospital  with suspected fibromyalgia

        Increased cancer risk in patients referred to hospital with suspected
        fibromyalgia.

        J Rheumatol. 2007 Jan;34(1):201-6.

        Dreyer L, Mellemkjaer L, Kendall S, Jensen B, Danneskiold-Samsøe B, Bliddal H.

        From The Parker Institute, Department of Rheumatology, Frederiksberg
        Hospital, Frederiksberg; Institute of Cancer Epidemiology, Danish Cancer
        Society, Copenhagen; and Multidisciplinary Pain Centre, H:S Rigshospitalet,
        Copenhagen, Denmark.

        PMID: 17216687


        OBJECTIVE: To analyze whether fibromyalgia (FM) and FM-like symptoms are
        related to an increased incidence of cancer.

        METHODS: We identified 1361 patients referred on suspicion of FM in the
        period 1984-99 from hospital records. Following the American College of
        Rheumatology (ACR) criteria, patients were divided into subgroups with and
        without confirmed FM. The cohort was followed to the end of 1999 and linked
        to the files of the Danish Cancer Register. Site-specific standardized
        incidence ratios (SIR) were calculated.

        Results. We found no association between FM and cancer in 1132 female
        patients with confirmed FM at our institution (SIR 1.2, 95% CI 0.8-1.8). In
        106 women referred for muscle pain and/or tenderness who did not meet the
        criteria for FM, an increased overall SIR was observed (SIR 2.5, 95% CI
        1.2-4.6), with increased risk for breast cancer (SIR 4.8, 95% CI 1.6-11.3)
        and lymphatic and hematological cancers (SIR 10.6, 95% CI 1.2-38.2). There
        were 4 lung cancers in 84 men with confirmed FM (SIR 12.6, 95% CI 3.4-32.4).

        Conclusion. Neither confirmed FM nor those without confirmed FM predicted
        cancer. An increased risk of breast cancer was found among those who did
        not meet the ACR criteria for FM. These patients should be investigated if
        they develop any new or warning symptoms of malignancy, and treating
        physicians should be vigilant with screening procedures such as mammography.

    [Return to top]

    ------------------------------

        Date:    Sun, 14 Jan 2007 17:09:50 -0500
        From:    "Bernice A. Melsky" <bernicemelsky@xxxxx.xxx>
        Subject: RES: Musculoskeletal Pain in Malaysia: A COPCORD Survey

        Musculoskeletal Pain in Malaysia: A COPCORD Survey.

        J Rheumatol. 2007 Jan;34(1):207-13.

        Veerapen K, Wigley RD, Valkenburg H.

        PMID: 17216688


        OBJECTIVE: To assess the nature and extent of rheumatic complaints in a
        semirural area in a multiracial (Malay, Indian, Chinese) community in
        Malaysia using the Community Oriented Program for the Control of Rheumatic
        Diseases (COPCORD) protocol initiated by ILAR and the WHO.

        METHODS: All members of a community of 2700 persons over the age of 15
        years were offered a questionnaire based interview in Phase 1 of the study.
        Those with rheumatic complaints (pain in the last 1 week) were invited for
        a physical examination by a rheumatologist in Phase 2.

        RESULTS: In total, 2594 (96%) persons agreed to a questionnaire based
        interview. Of those interviewed, 21.1% had a current rheumatic complaint.
        The pain rate was higher in women (23.8%) than in men (17.8%). Chinese men
        had the lowest age-standardized pain rate (9.9%), while Indian women had
        the highest rate (28.4%). In the study population, 14.4% complained of pain
        in the joints and/or musculoskeletal pain and 11.6% had low back pain. The
        knee was responsible for 64.8% of all complaints pertaining to the joints,
        and more than half those examined with knee pain had clinical evidence of
        osteoarthritis (OA). The complaint rate increased with age, up to 53.4% in
        the group age > 65 years. The major disability encountered was the
        inability to squat (3.1%). Fibromyalgia, soft tissue lesions, and localized
        OA of the knees were the main clinical diagnoses. Inflammatory arthritis
        was uncommon. Both Western and traditional sources of healthcare were used,
        often together. Self-medication was common (58.8%).

        Conclusion. Knee and back pain are the main rheumatic complaints in
        Malaysia, with complaint rates differing according to race and gender.

    [Return to top]

    ------------------------------

        Date:    Mon, 15 Jan 2007 14:20:49 -0800
        From:    Co-Cure Moderators <bookbear13@xxxxx.xxx>
        Subject: MED:  Medically Unexplained Physical Symptoms to be posted

        Moderators Note:  Resent for 
ogerin@xxxxx.xxx

        Please contact the PR Director named  rather than the moderators for further information on the following post as we have no further statistics nor contact information than is listed.



        MEDICALLY UNEXPLAINED PHYSICAL SYMPTOMS

        The National ME/FM Action Network welcomes Statistics Canadas study
        on Medically Unexplained Physical Symptoms.

        The study confirms what the National ME/FM Action Network has observed
        over its twelve (12) years of advocacy and support for Canadians with
        Chronic Fatigue Syndrome (CFS) and Fibromyalgia (FM)  that CFS and FM are
        widespread and that patients with these illnesses have high degrees of
        disability.

        Lydia Neilson, M.S.M., president of the National ME/FM Action Network,
        hopes that this study will lead to more research into these illnesses and to
        better health and social support for those with the illnesses. Ms Neilson
        emphasizes the importance of early diagnosis and treatment to prevent
        the conditions from becoming chronic.

        The National ME/FM Action Network, with the information now provided by
        Statistics Canada, is more and more determined to pursue its goal of
        advancing the recognition and understanding of Chronic Fatigue Syndrome
        and Fibromyalgia through education, advocacy, support and research.



        Odile Gerin, public relations director,
        National ME/FM Action Network

    [Return to top]

    ------------------------------

End of Co-Cure Weekly Digest of research and medical posts only - 8 Jan 2007 to 15 Jan 2007