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Co-Cure Weekly Digest of research and medical posts only - 5 Feb 2007 to 12 Feb 2007

Topics of the week:
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                       This is a special digest of
                  Co-Cure Research & Medical posts only
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Date:    Tue, 6 Feb 2007 17:24:17 -0500
From:    Co-Cure Moderator <ray CO-CURE.ORG>
Subject: NOT,MED: March 10, 2007 NJCFSA Spring Conference & CAA's "kNOw  MORE CFS" seminar

There is a new, professionally rendered announcement for the
March 10, 2007 conference co-hosted by the New Jersey CFS
Association and the CFIDS Association of America available
in PDF at

[AOL: <a href="http://www.co-cure.org/NJ.pdf">Here</a>]

We urge you to take a moment to look at it.

The main points of the announcement are as follows:

In March the New Jersey Chronic Fatigue Syndrome Association
and the CFIDS Association of America will join forces
to bring you a special event that combines the
spring conference of the NJCFSA with the
CFIDS Association’s popular kNOw MORE CFS seminar series.

Date: Saturday, March 10, 2007
Place: Robert Wood Johnson University Hospital
Time: 11:00 a.m. to 5:15 p.m.

The conference will include three key sessions:
1) The CFS Public Awareness Campaign session. This session
will include a showing of the campaign public service announcements,
video clips of key media coverage and an overview of campaign goals
and highlights from CFIDS Association president and CEO Kimberly
McCleary. In addition, Jacqueline Niederle and Brian Bernard, two photo
exhibit participants, will share their personal experiences as patients and

2) Research session. Dr. Nancy Klimas, University of Miami

3) Clinical session. Dr. Alan Pocinki, internal medicine practice

The new traveling CFS photo exhibit, “The Faces of Chronic Fatigue
Syndrome,” will be displayed from March 9-12 in the Arline and Henry
Schwartzman Courtyard (atrium) at Robert Wood Johnson University
Hospital, in New Brunswick, New Jersey. It can be viewed by conference
participants on March 10. The compelling exhibit features portraits and
stories of patients (including three past and present NJCFSA members),
family members and health care professionals. It’s part of the national
CFS Public Awareness Campaign sponsored by the CDC and the CFIDS
Association of America.

Mark your calendars and save the date!

Additional information is available on the NJCFSA website at www.njcfsa.org
and on the CFIDS Association of America’s website at www.cfids.org.
Early registration is recommended as seating is limited.

[Thanks to Eileen Holderman, Chair of the NJCFSA
Publicity Committee for providing us with the PDF

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Date:    Tue, 6 Feb 2007 19:45:20 -0500
From:    "Diane Rose <diane dianerose.com> via Co-Cure Moderator"
Subject: NOT,RES:  Boston-based medical study seeks POTS subjects [US]

Permission to re-post:

Roy Freeman, MD and his research staff at the Center for Autonomic and
Peripheral Nerve Disorders at Boston's Beth Israel Deaconess Medical Center
(a teaching hospital of Harvard Medical School) are conducting a number of
studies of patients with POTS (Postural Tachycardia Syndrome) and they are
actively seeking subjects (who have postural tachycardia syndrome).  This
is how they describe the studies:

"The aim of our research project is to identify the possible
pathophysiological mechanisms of the postural tachycardia syndrome by
applying an integrated physiological-experimental approach.  The approach
includes carotid artery and brachial artery ultrasound examination,
different autonomic evaluation techniques such as arterial baroreflex
assessment, cardiovascular response monitoring to different stress tests,
calf blood flow measurement and sympathetic nerve activity recording.  The
research study also includes pharmacological assessment of the arterial
baroreflex function and the increase of this parasympathetic control by low
dose atropine and losartan.  Using all of these techniques, our research
study provides information simultaneously about several aspects of the
cardiovascular autonomic control mechanisms in postural tachycardia
syndrome and facilitates our understanding of the sympathetic vascular and
cardiac autonomic controls in this disorder.

The research study consists of a screening visit and 4 study visits [to
Boston's Beth Israel Deaconess Medical Center].  it is optional to stay in
the hospital before [or during] the study days.  Discontinuation of
medications may be necessary for the study but you may discontinue any
medication only with the approval of your Primary Care Physician and Dr.

The studies appear to be quite flexible and you can choose to do some, all
or none of the pieces of it.  There is modest compensation for your
time.  If you would like to find out more about the study, please contact
Dr. Bonyhay (MD, PhD Research Fellow) at 617-632-0646.

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Date:    Wed, 7 Feb 2007 12:45:13 +0000
From:    Maggie Wallace <zen38947 ZEN.CO.UK>
Subject: RES,MED: IACFS Prof Conf I: Cardiovascular and Exercise Studies

Posted on behalf of cort johnson <phoenixcfs yahoo.com>

Welcome to another Special Edition of Phoenix Rising. This issue begins
  the coverage of the Professional Section of the  exciting 8th IACFS
Conferrence held in Fort Lauderdale, Florida from Jan 12th-14. This
section provides an overview of the Introduction to the Fatigue Section
and to studies on Cardiovascular/Vascular and Exercise Testing . These
studies appear to indicate that some things are starting to come
together in CFS reserach, Keep your eye open for studies implicating the
cardiovascular sytem, infllammation and the mitochondria.

The next section will be on the Brain and Genetics

You can access this section by clicking on the below URL


Please subscribe to Phoenix Rising!

  Happy reading!


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Date:    Wed, 7 Feb 2007 14:53:29 -0500
From:    Co-Cure Moderator <ray CO-CURE.ORG>
Subject: NOT,RES: Neurobiological Differences Found in CFS

Neurobiological Differences Found in CFS

At the recent IACFS conference, researcher Paul Nestadt described findings
from a study of neurometabolites in CFS undertaken by a team of researchers
led by Dr. Dikoma Shungu and funded by the CFIDS Association.

In an attempt to understand the neurobiological effects of CFS and to
discern potential biomarkers for the illness, these researchers used
cross-sectional neuroimaging to compare regional brain metabolite levels
and to examine the association of the neurochemical findings with the
symptomology of the illness.

Read the complete article at

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Date:    Wed, 7 Feb 2007 15:22:35 -0500
From:    Fred Springfield <fredspringfield VERIZON.NET>
Subject: RES: Enhanced feedback sensitivity to prednisolone in chronic  fatigue syndrome

Enhanced feedback sensitivity to prednisolone in chronic fatigue syndrome.

Journal: Psychoneuroendocrinology. 2007 Feb 2; [Epub ahead of print]

Authors: Jerjes WK, Taylor NF, Wood PJ, Cleare AJ.

Affiliation: Department of Clinical Biochemistry, Guy's, King's and St
Thomas' School of Medicine, Bessemer Road, London SE5 9RS, UK.

NLM Citation: PMID: 17276605

Objective: Enhancement of negative feedback control of the HPA axis in
patients with chronic fatigue syndrome (CFS) has been reported using the
low dose dexamethasone suppression test. We have developed the use of
prednisolone (5mg) as a more physiologically appropriate alternative to
dexamethasone in the investigation of mild degrees of glucocorticoid
resistance or supersensitivity. The objective of the study was to use this
test to look for alterations in negative feedback control of the HPA axis
in CFS patients.

Methods: Fifteen patients with CFS were recruited after fulfilling strict
criteria including the absence of comorbid psychiatric diagnosis. They
collected urine between 0900 and 1800h and saliva at 0900h
pre-prednisolone. At midnight, they took prednisolone (5mg) orally and then
collected urine and saliva at the same intervals the following day.

Results: Salivary cortisol was lower in CFS subjects pre-prednisolone than
controls. Urinary cortisol metabolites were lower in CFS subjects
pre-prednisolone, but did not reach significance. Both measures were
significantly lower in CFS subjects post-dose. Mean percentage suppression
of both salivary cortisol and urinary cortisol metabolites was
significantly higher in CFS compared to controls.

Conclusion: There is enhanced sensitivity of the HPA axis to negative
feedback in CFS as demonstrated using the prednisolone suppression test.
This provides further evidence of alterations in the control of the HPA
axis in patients with established CFS.

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Date:    Thu, 8 Feb 2007 13:53:04 -0500
From:    Fred Springfield  <fredspringfield VERIZON.NET>
Subject: RES: An 'Overwhelming Illness': Women's Experiences of Learning to Live with Chronic Fatigue Syndrome/Myalgic Encephalomyelitis

An 'Overwhelming Illness': Women's Experiences of Learning to Live with
Chronic Fatigue Syndrome/Myalgic Encephalomyelitis.

Journal: J Health Psychol. 2007 Mar;12(2):203-14.

Edwards CR, Thompson AR, Blair A.

Barnsley Primary Care Trust, UK. catherine.edwards@barnsleypct.nhs.uk.

NLM Citation: PMID: 17284485

The processes through which people learn to live with CFS/ME are poorly
understood and have not been rigorously explored within the literature. Semi-
structured interviews were conducted with eight women and analysed using
interpretative phenomenological analysis.

Participants initially described being 'overwhelmed' by CFS/ME. Attempts at
seeking help were unsatisfactory and participants described feeling let
down and disbelieved. Participants reacted to this by identifying types of
'self-help' and assertively taking more responsibility for their illness
and its treatment.

Acquiring social support and greater knowledge were key mediating factors
in the emergence of control and acceptance. The relevance of the themes to
existing research and the implications for clinical practice are considered.

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Date:    Thu, 8 Feb 2007 14:14:25 -0500
From:    "Bernice A. Melsky" <bernicemelsky VERIZON.NET>
Subject: RES: Fibromyalgia treatment update

Fibromyalgia treatment update.

Curr Opin Rheumatol. 2007 Mar;19(2):111-7.

Rooks DS.

Division of Rheumatology and the Center for the Study of Nutrition
Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School,
Boston, Massachusetts, USA.

PMID: 17278924

PURPOSE OF REVIEW: Fibromyalgia is a common chronic pain disorder
characterized by complex symptomatology and few consistently effective
treatments. The purpose of this review is to highlight the recent
literature from April 2005 through September 2006 involving treatment options.

RECENT FINDINGS: Prior evidence suggests that medication and
self-management approaches to care can improve symptoms, function and
well-being in this patient population. Recent studies examining the
efficacy of two serotonin and norepinephrine-reuptake inhibitors -
duloxetine and milnacipran - and the anticonvulsant pregabalin are
encouraging. Studies evaluating different forms of exercise continue to
support the belief that increased physical activity is an essential
component of any treatment plan for the patient with fibromyalgia. Three
studies added to the understanding of treatment adherence. Finally, three
studies evaluating the efficacy of acupuncture in the treatment of
fibromyalgia showed conflicting results, but added to the knowledge needed
for clinicians to have substantive conversations with patients.

SUMMARY: Recent studies support the recommendation of a multimodal approach
to treatment involving individualized, evidence-based pharmacotherapy and
self-management. Treatment goals should include the improvement of
symptoms, primarily pain and sleep, and the promotion of positive health
behaviors with the aim of improving physical function and emotional well-being.

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Date:    Thu, 8 Feb 2007 14:11:37 -0500
From:    "Bernice A. Melsky" <bernicemelsky VERIZON.NET>
Subject: RES: A Randomized Controlled Trial on the Effectiveness of  Mild Water-filtered Near Infrared Whole-body Hyperthermia as an  Adjunct to a Standard Multimodal Rehabilitation in the Treatment of  Fibromyalgia

A Randomized Controlled Trial on the Effectiveness of Mild Water-filtered
Near Infrared Whole-body Hyperthermia as an Adjunct to a Standard
Multimodal Rehabilitation in the Treatment of Fibromyalgia.

Clin J Pain. 2007 Jan;23(1):67-75.

Brockow T, Wagner A, Franke A, Offenbacher M, Resch KL.

*Spa Medicine Research Institute Bad Elster, Lindenstr. 5, 08645 Bad
Elster, Germany daggerRehabilitation Hospital Hoher Meissner, Hardtstr. 36,
37242 Bad Sooden-Allendorf double daggerDepartment of Medical Psychology at
the University of Munich, 80336 Munchen.

PMID: 17277647

OBJECTIVES: To evaluate whether mild water-filtered near infrared
whole-body hyperthermia (NI-WBH) produces an additional benefit when
applied as an adjunct to a standard multimodal rehabilitation (MR) compared
with MR only in patients with fibromyalgia (FM).

METHODS: One hundred thirty-nine patients of a German inpatient
rehabilitation hospital meeting the ACR 1990 criteria for FM were randomly
allocated to NI-WBH (heating-up to 38.1 degrees C body core temperature
followed by a 15 min heat retention period) and MR or MR only, twice a week
over 3 weeks. Main outcome measures were affective and sensory pain
assessed by a German version of the McGill Pain Questionnaire, measured at
baseline, postintervention, 3 and 6 months postintervention and analyzed by
intention to treat.

RESULTS: Repeated measures analysis of covariance showed significant
differences between groups for both primary outcome measures in favor of
NI-WBH and MR compared with MR only (P<0.001 for affective pain, P=0.001
for sensory pain). Secondary analyses on pain intensity, FM-related quality
of life and tender point assessment yielded similar results. Moderate
effect sizes were observed for all outcome measures considered (range, 0.41
to 0.75). NI-WBH related side effects were observed in 14 of 69
participants (20%) but all disappeared in less than 30 minutes.

DISCUSSION: The study indicates that NI-WBH is a worthwhile adjunct to MR
in the treatment of FM.

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Date:    Thu, 8 Feb 2007 14:17:33 -0500
From:    "Bernice A. Melsky" <bernicemelsky VERIZON.NET>
Subject: RES: Pool exercise for individuals with fibromyalgia

Pool exercise for individuals with fibromyalgia.

Curr Opin Rheumatol. 2007 Mar;19(2):168-73.

Gowans SE, Dehueck A.

Allied Health, University Health Network; Department of Physical Therapy,
University of Toronto; Therapy Services Department, Joseph Brant Memorial
Hospital, Toronto, Ontario, Canada.

PMID: 17278933

PURPOSE OF REVIEW: The benefits of general aerobic exercise for individuals
with fibromyalgia have been established. Recently, there have been a number
of randomized controlled trials that evaluate the benefits of pool exercise
for fibromyalgia. This review will integrate the results of eight pool
exercise studies that have been published in the last 7 years.

RECENT FINDINGS: Pool exercise has been evaluated against sedentary control
groups, land-based exercise and immersion in a warm, mineralized pool. Pool
exercise has been shown to be as effective as land-based exercise and may
have greater benefits with respect to mood and sleep duration. Based on
follow-up studies, exercise-induced improvements in physical function, pain
and mood may persist for up to 2 years. Pool exercise may be better
tolerated as an initial means of exercise by individuals with arthritis in
weight-bearing joints (because of water buoyancy) or by individuals who
fear exercise will exacerbate their pain.

SUMMARY: Pool exercise can be an effective intervention for individuals
with fibromyalgia. Future studies should reassess subjects at multiple time
points to determine the time course of exercise-induced improvements and
further explore the effects of pool exercise on mood and sleep quality.

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Date:    Fri, 9 Feb 2007 11:59:21 -0500
From:    Fred Springfield <fredspringfield VERIZON.NET>
Subject: RES: Cortisol and severe fatigue: A longitudinal study in  adolescent girls

Cortisol and severe fatigue: A longitudinal study in adolescent girls.

Journal: Psychoneuroendocrinology. 2007 Feb 5; [Epub ahead of print]

Authors: Ter Wolbeek M, van Doornen LJ, Coffeng LE, Kavelaars A, Heijnen CJ.

Affiliations: Laboratory of Psychoneuroimmunology, University Medical
Center Utrecht, Office KC03.068.0, P.O. Box 85090, 3508 AB, Utrecht, The
Netherlands; Department of Health Psychology, Utrecht University, P.O. Box
80140, 3508 TC Utrecht, The Netherlands.

NLM Citation: PMID: 17287088

Fatigue is a common complaint among adolescents, especially in girls, and
is associated with high rates of school absenteeism. Severe fatigue is
often accompanied by psychological and physical symptoms. In the chronic
fatigue syndrome (CFS) functioning of the hypothalamic-pituitary-adrenal
(HPA)-axis has previously been found to be altered. The aim of the present
study was to investigate whether cortisol production is deviant in fatigued
adolescent girls from the general population and to study longitudinal
changes in fatigue in association with possible changes in HPA-axis

In the cross-sectional part of the study the cortisol response to awakening
(CAR) and to a low-dose oral dexamethasone were examined in a group of
fatigued adolescent girls (n=87) in comparison to a non-fatigued control
group (n=77). Questionnaires regarding fatigue, depression, anxiety, sleep
quality, somatic symptoms and CFS-related symptoms were filled out. Follow
up measurements were performed after 6 and 12 months.

While the fatigued and non-fatigued group differed remarkably on all
symptom self-reports, no differences between groups in CAR and response to
dexamethasone were observed. Girls in the fatigued group remained fatigued
over time and reported high levels of other psychological and physical
symptoms during the whole year of the study. The CAR varied between time
points but correlated non-systematically with situational characteristics
or symptom reports.

We conclude that trait-like fatigue, as measured in a sample of adolescent
girls from a high school population, is not reflected in a dysregulation as
assessed on the level of salivary cortisol after awakening.

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Date:    Fri, 9 Feb 2007 12:00:06 -0500
From:    "Bernice A. Melsky" <bernicemelsky VERIZON.NET>
Subject: RES: Treatment approaches for painful bladder  syndrome/interstitial cystitis

Treatment approaches for painful bladder syndrome/interstitial cystitis.

Drugs. 2007;67(2):215-35.

Theoharides TC.

Departments of Pharmacology and Experimental Therapeutics, Biochemistry and
Internal Medicine, Tufts University School of Medicine, Tufts-New England
Center, Boston, Massachusetts, USA.

PMID: 17284085

Painful bladder syndrome/interstitial cystitis (PBS/IC) is a disease of
unknown aetiology, characterised by severe pressure and pain in the bladder
area or lower pelvis that is frequently or typically relieved by voiding,
along with urgency or frequency of urination in the absence of urinary
tract infections. PBS/IC occurs primarily in women, is increasingly
recognised in young adults, and may affect as many as 0.1-1% of adult women.

PBS/IC is often comorbid with allergies, endometriosis, fibromyalgia,
irritable bowel syndrome and panic syndrome, all of which are worsened by
stress. As a result, patients may visit as many as five physicians,
including family practitioners, internists, gynaecologists, urologists and
pain specialists, leading to confusion and frustration.

There is no curative treatment; intravesical dimethyl sulfoxide, as well as
oral amitriptyline, pentosan polysulfate and hydroxyzine have variable
results, with success more likely when these drugs are given together.
Pilot clinical trials suggest that the flavonoid quercetin may be helpful.

Lack of early diagnosis and treatment can affect outcomes and leads to the
development of hyperalgesia/allodynia.

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Date:    Fri, 9 Feb 2007 12:05:38 -0500
From:    "Bernice A. Melsky" <bernicemelsky VERIZON.NET>
Subject: RES: Fibromylagia,Chronic fatigue, and adult attention deficit  hyperactivity disorder in the adult: a case study

Fibromylagia,Chronic fatigue, and adult attention deficit hyperactivity
disorder in the adult: a case study.

Psychopharmacol Bull. 2007 Winter;40(1):118-26.

Young JL, Redmond JC.

Rochester Center for Behavioral Medicine, Rochester Hills, MI.

PMID: 17285103

Adult attention deficit hyperactivity disorder (ADHD) may share common
features with fibromyalgia syndrome (FMS) and chronic fatigue syndrome (CFS).

In an outpatient psychiatric clinic, a number of adult patients who
presented primarily with symptoms of ADHD, predominately inattentive type,
also reported unexplained fatigue, widespread musculoskeletal pain or a
pre-existing diagnosis of CFS or FMS.

As expected, ADHD pharmacotherapy usually attenuated the core ADHD symptoms
of inattention, distractibility, hyperactivity, and impulsivity. Less
expected was the observation that some patients also reported amelioration
of pain and fatigue symptoms.

The utility of ADHD medications in FMS and CFS states may be their innate
arousal and enhanced filtering properties.

This model supposes that FMS and CFS are central processing problems rather
than peripheral disorders of muscles and joints.

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Date:    Fri, 9 Feb 2007 12:33:46 -0500
From:    "David Axford <axford worldonline.co.uk> via Co-Cure Moderator"
Subject: NOT,RES: Latest ME Research

The latest ME & CFS References are now available at:
< http://freespace.virgin.net/david.axford/melist.htm>

Click on the:
"Latest Research" button which is in the left-hand column.
You'll then see the "ME/CFS References " clearly marked 1st March 2007 in
the right hand frame. This has a "NEW" graphic alongside. Click on the
button (microscope on top of the globe).

You may also find the article using the SEARCH tool which is on the home page.

It is possible that your browser won't log on first time due to the large
number of people who are accessing the web-site. Please be patient and try
again at different times when it's less busy.

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Date:    Sat, 10 Feb 2007 18:17:58 -0500
From:    "Bernice A. Melsky" <bernicemelsky VERIZON.NET>
Subject: RES: Is further evaluation for growth hormone (GH) deficiency necessary in fibromyalgia patients with low serum insulin-like growth  factor (IGF)-I levels?

Is further evaluation for growth hormone (GH) deficiency necessary in
fibromyalgia patients with low serum insulin-like growth factor (IGF)-I levels?

Growth Horm IGF Res. 2007 Feb 5; [Epub ahead of print]

Yuen KC, Bennett RM, Hryciw CA, Cook MB, Rhoads SA, Cook DM.

Department of Endocrinology, Oregon Health and Science University, 3181 SW
Sam Jackson Park Road, Mailcode L607, Portland, OR 97239-3098, USA.

PMID: 17289417

OBJECTIVE: Fibromyalgia (FM) is characterized by diffuse pain, fatigue, and
sleep disturbances; symptoms that resemble the adult growth hormone (GH)
deficiency syndrome. Many FM patients have low serum GH levels, with a
hypothesized aetiology of dysregulated GH/insulin-like growth factor
(IGF)-I axis. The aim of this study was to assess the GH reserve in FM
patients with low serum IGF-I levels using the GH-releasing hormone
(GHRH)-arginine test.

DESIGN: We retrospectively reviewed the GHRH-arginine data of 77 FM
patients with low serum IGF-I levels referred to our tertiary unit over a
4-year period.

RESULTS: Of the 77 FM patients, 13 patients (17%) failed the GHRH-arginine
test. Further evaluation with pituitary imaging revealed normal pituitary
glands (n=7), coincident microadenomas (n=4), empty sella (n=1) and
pituitary cyst (n=1), and relevant medical histories such as previous head
injury (n=4), Sheehan's syndrome (n=1), and whiplash injury (n=1). In
contrast, the remaining 64 patients (83%) that responded to the
GHRH-arginine test demonstrated higher peak GH levels compared to age and
BMI-matched controls (n=24).

CONCLUSION: Our data shows that a subpopulation of FM patients with low
serum IGF-I levels will fail the GHRH-arginine test. We, thus, recommend
that the GH reserve of these patients should be evaluated further, as GH
replacement may potentially improve the symptomatology of those with true
GH deficiency. Additionally, the increased GH response rates to
GHRH-arginine stimulation in the majority of FM patients with low serum
IGF-I levels further supports the hypothesis of a dysregulated GH/IGF-I
axis in the pathophysiology of FM.

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Date:    Sun, 11 Feb 2007 00:56:36 +0000
From:    Maggie Wallace <zen38947 ZEN.CO.UK>
Subject: NOT,MED: Zolpidem, sold under the brand names Ambien, Stilnoct and Stilnox

May be of interest to readers and subscribers taking sleep medication.

Sleep medication linked to bizarre behaviour

     * 12:44 06 February 2007
     * NewScientist.com news service
     * Roxanne Khamsi

New evidence has linked a commonly prescribed sleep medication with
bizarre behaviours, including a case in which a woman painted her front
door in her sleep.

UK and Australian health agencies have released information about 240
cases of odd occurrences, including sleepwalking, amnesia and
hallucinations among people taking the drug zolpidem.


The US Food and Drug Administration says it is continuing to "actively
investigate" and collect information about cases linking zolpidem to
unusual side effects.

The Ambien label currently lists strange behaviour as a “special
concern” for people taking the drug. “It’s a possible rare adverse
event,” says Sanofi-Aventis spokesperson Melissa Feltmann, adding that
the strange sleepwalking behaviours “may not necessarily be caused by
the drug” but instead result from an underlying disorder. She says that
“the safety profile [of zolpidem] is well established”. The drug
received approval in the US in 1993.

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Date:    Sun, 11 Feb 2007 00:13:59 -0500
From:    "Barbara Soliday <bsoliday miami.edu> via Co-Cure Moderator"
Subject: NOT,MED: Sleep diagnosis without going to a sleep center

This study may be good news if people want to try out a C-PAP machine
without the expense and difficulty of going to a sleep center.

Barbara Soliday

New York Times
February 6, 2007
Vital Signs

Diagnosis: An Easier Path to the Treatment of Sleep Apnea



People who have obstructive sleep apnea know how hard it can be to adjust to the
breathing apparatus used to treat it. But just getting a diagnosis poses its own
challenges, generally requiring two nights hooked up to wires in a sleep

Now researchers say there is an easier way that allows some patients to stay at
home. Instead of going to a laboratory, patients who are good candidates for an
apnea diagnosis are given treatment right away, with portable equipment being
used to assess their response.

Writing in the current Annals of Internal Medicine, the researchers say the
method can speed up diagnoses and treatment for those with the disorder,
which causes people to wake up repeatedly when they stop breathing. The
condition can lead to fatigue, high blood pressure and other health problems.

Patients thought to have sleep apnea are usually sent to specialized centers to
be evaluated. Only after that are they given machines that send air into the
lungs while they sleep, known as C-PAPs. But the visits are expensive, the
waiting lists are long, and many people do not live near a sleep center.

For the study (see http://www.annals.org/cgi/content/abstract/146/3/157 ), the
researchers screened patients to come up with a group they considered at least
90 percent likely to have the condition. The patients were then given either a
standard evaluation at a laboratory or an at-home one, with C-PAP use beginning
immediately. When the patients were re-examined, researchers found that those
who went to the laboratory did no better than the other patients, said Dr. C.
Frank Ryan of the University of British Columbia, the senior author of the
study. The lead author was Alan T. Mulgrew of the Vancouver Public Health
System in Canada.

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End of Co-Cure Weekly Digest of research and medical posts only - 5 Feb 2007 to 12 Feb 2007

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