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Posted to Co-Cure Sat, 30 Oct 1999 18:44:04 -0400

Mycoplasmal Infections in Chronic Illnesses

Mycoplasmal Infections in Chronic Illnesses: Fibromyalgia and Chronic Fatigue Syndromes, Gulf War Illness, HIV-AIDS and Rheumatoid Arthritis
Medical Sentinel, Volume 4, Number 5, September/October 1999, pp. 172-175, 191.
Garth L. Nicolson, PhD, Marwan Y. Nasralla, PhD, Joerg Haier, MD, PhD, Robert Erwin, MD, Nancy L. Nicolson, PhD, Richard Ngwenya, MD

Abstract:
Invasive bacterial infections are associated with several acute and chronic illnesses, including: aerodigestive diseases such as Asthma, Pneumonia, Inflammatory Bowel Diseases; rheumatoid diseases, such as Rheumatoid Arthritis (RA); immunosuppression diseases such as HIV-AIDS; genitourinary infections and chronic fatigue illnesses such as Chronic Fatigue Syndrome (CFS), Fibromyalgia Syndrome (FMS) and Gulf War Illnesses (GWI). It is now apparent that such infections could be (a) causative, (b) cofactors or (c) opportunistic agents in a variety of chronic illnesses. Using Forensic Polymerase Chain Reaction we have looked for the presence of one class of invasive infection (mycoplasmal infections) inside blood leukocyte samples from patients with CFS (Myalgic Encephalomyelitis), FMS, RA, and GWI. There was a significant difference between symptomatic CFS, FMS, GWI, and RA patients with positive mycoplasmal infections of any species (45-63%) and healthy positive controls (~9%) (P<0.001). This difference was even greater when specific species (M. fermentans, M. hominis, M. penetrans, M. pneumoniae) were detected. Except for GWI, most patients had multiple mycoplasmal infections (more than one species of mycoplasma). Patients with different diagnoses but overlapping signs and symptoms often have mycoplasmal infections, and such mycoplasma-positive patients generally respond to multiple cycles of particular antibiotics (doxycycline, minocycline, ciprofloxacin, azithromycin, and clarithromycin). Multiple cycles of these antibiotics plus nutritional support appear to be necessary for successful treatment. In addition, immune enhancement and other supplements appear to help these patients regain their health. Other chronic infections may also be involved to various degrees with or without mycoplasmal infections in causing patient morbidity in various chronic illnesses.

[ The full text of the article is available at http://www.haciendapub.com/article24.html ]

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Posted to Co-Cure Fri, 29 Oct 1999 18:51:53 -0400

Hyposecretion of adrenal androgens and the relation of serum adrenal steroids, serotonin and insulin-like growth factor-1 to clinical features in women with fibromyalgia

Hyposecretion of adrenal androgens and the relation of serum adrenal steroids, serotonin and insulin-like growth factor-1 to clinical features in women with fibromyalgia.
Authors: Dessein PH, Shipton EA, Joffe BI, Hadebe DP, Stanwix AE, Van der Merwe BA
Rheumatology Unit, Milpark Hospital, Johannesburg, South Africa
Journal: Pain 1999 Nov 1;83(2):313-319
NLM citation: PMID: 10534604

The authors studied adrenal androgen metabolites and their relationship with health status in 57 female FMS patients and correlated results to those for serum (blood) levels of other implicated neuroendocrine mediators. Measurements were taken of dehydroepiandrosterone sulphate (DHEAS), free testosterone (T), cortisol, serotonin and insulin-like growth factor-1. Low serum androgen levels correlated with poor health status in FMS. http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?uid=10534604&form=6&db=m&Dopt=b

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Posted to Co-Cure Tue, 5 Oct 1999 18:00:53 -0400

Evaluations of 4 health status measurements in reference to CFS/FMS patients

These three studies looked at the usefulness of four tests for evaluating the health status in patients with chronic fatigue syndrome or fibromyalgia. The tests discussed are:

(1) The EuroQoL EQ-5D - developed as a generic measurement of mobility, self care, usual activities, pain or discomfort, and anxiety or depression.
http://www.eur.nl/bmg/imta/eq-net/EQ5d.htm

(2) The SF-36 is a 36-question test of physical and emotional well-being (http://www.sf-36.com/). You can take a sample test and see your results in comparison to the national mean at http://www.qmetric.com/products/assessments/sf36/demo.php3

(3) The Arthritis Impact Measurement Scales (http://www.qlmed.org/aims/)

(4) The Western Ontario and McMaster Universities (WOMAC) Osteoarthritis Index - a disease-specific, self-administered, and measures pain, stiffness and physical function.


Comparison of Euroqol EQ-5D and SF-36 in patients with chronic fatigue syndrome.
Authors: Myers C, Wilks D; Regional Infectious Diseases Unit, Western General Hospital, Edinburgh, UK.
Journal: Qual Life Res 1999;8(1-2):9-16
NLM citations: PMID: 10457734, UI: 99386184

http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?uid=10457734&form=6&db=m&Dopt=b

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Posted to Co-Cure Tue, 26 Oct 1999 23:44:01 -0400 by Fred Springfield

Prevalence and Overlap of CFS and FMS Among 100 New Patients with MCS

Prevalence and Overlap of Chronic Fatigue Syndrome and Fibromyalgia Syndrome Among 100 New Patients with Multiple Chemical Sensitivity Syndrome

Journal of Chronic Fatigue Syndrome (The Haworth Medical Press, an imprint of The Haworth Press, Inc.) Vol. 5, No. 3/4, 1999

Albert Donnay, MHS
Grace Ziem, MD, DrPH

SUMMARY.
Background: Several studies have reported on extensive two-way overlaps found among chronic fatigue syndrome (CFS), fibromyalgia syndrome (FMS) and multiple chemical sensitivity syndrome (MCS) but none have yet reported on the overlap of all three. This study assesses the prevalence of pure MCS, MCS-CFS, MCS-FMS and the overlap of all three among 100 consecutive new patients evaluated for MCS in a private practice specializing in occupational and environmental medicine.

Methods: Sixty-eight females and 32 males diagnosed with MCS - based on a medical history of multiple chronic symptoms in multiple organs triggered by multiple chemical exposures at or below previously tolerated levels - were also evaluated for CFS and FMS using the diagnostic criteria of the US Centers for Disease Control and the American College of Rheumatology, respectively.

Results: Eighty-eight percent of the 100 MCS patients met criteria for CFS, 49% met criteria for FMS, and 47% met both. Slightly more male than female MCS patients had CFS: 91% vs. 87%; while FMS was more than twice as common among female MCS patients: 59% vs. 28%. The majority of women, 56%, met criteria for all three disorders, and an additional 31% had both MCS and CFS. This pattern was reversed in men, only 28% of whom had all three, compared to 63% with MCS and CFS but no FMS. MCS alone was diagnosed in only 10% of the women and 9% of the men. Even rarer was the overlap of MCS and FMS without any CFS, found in just 2 women.

Conclusions: At least in this clinic population, MCS seldom occurs alone. The enormous range of diagnostic overlaps reported here and in previous studies of various overlaps among CFS, EMS and MCS highlights the need to screen for all three disorders in studies of any one and to report results in these terms. We recommend this be made standard practice in both clinical settings and research protocols.

[ Article copies available for a fee from The Haworth Document Delivery Service: 1-800-342-9678. E-mail address: getinfo@haworthpressinc.com .]

KEYWORDS. Fatigue syndrome, chronic; fibromyalgia, multiple chemical sensitivity, prevalence, case series

Albert Donnay is President of MCS Referral & Resources, Inc.

Grace Ziem maintains a private practice specializing in chemical injury and is the co-founder of MCS Referral & Resources, Inc.

Address correspondence to: Albert Donnay, 508 Westgate Road, Baltimore, MD 21229.

The authors thank Dr. Ziem's staff, Bonnie Cook, Brenda Smith and Beth Demers for their assistance with reviewing medical records and data entry, and Mr. Donnay's assistant, Connie Prigg, for final preparation of the manuscript. They also thank Dr. Ann McCampbell for helpful comments on the manuscript.

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Posted to Co-Cure Sat, 23 Oct 1999 19:06:44 -0400 by Fred Springfield

Clinical and Pathogenetical Characterization of 238 Patients of a Chronic Fatigue Syndrome Italian Center

Clinical and Pathogenetical Characterization of 238 Patients of a Chronic Fatigue Syndrome Italian Center

Journal of Chronic Fatigue Syndrome (The Haworth Medical Press, an imprint of The Haworth Press, Inc.) Vol. 5, No. 3/4, 1999
Delia Racciatti, Annamaria Barbeno, Jacopo Veechiet, Eligio Pizzigallo

SUMMARY. Prolonged fatigue is a common complaint in the community and is usually transitory. If fatigue continues for more than six months, is disabling, and is accompanied by other constitutional and neuropsychiatric symptoms, then a diagnosis of chronic fatigue syndrome (CFS) should be considered.

CFS probably is an heterogeneous disease, maybe multifactorial, or it includes different pathologies which manifest with the same symptoms. In some cases, the mode of presentation of the illness implicate the exposure to chemical and/or food toxins as precipitating factors (e.g., ciguatera poisoning, Gulf War Syndrome, etc.). In other CFS cases, the etiology is still unknown: there are various hypotheses on pathogenetic events which, alone or in association with each other, may precipitate the illness. In fact, it is probable an involvement of multiple events in CFS onset where different precipitating factors can interact each other, even if not always all present in the single patient: latent and/or chronic viral infections, immunologic and neuroendocrine dysfunctions, psychological, environmental and mood factors.

In accordance to this theory, we consider various subgroups of CFS patients on the basis of the pathway and the mode of presentation of the disease. The Clinic of Infectious Diseases of "6. D'Annunzio" University of Chieti is one of the main National Reference Centers for the CFS Study in Italy. From January 1992 to January 1998, 238 patients came to our observation: 89 of them met CDC criteria for CFS (1994), 127 did not; the other 22 patients are still under evaluation. Our patients underwent physical examination (including tests for searching for the possible coexistence of a fibromyalgia syndrome), psychiatric interview with several neuropsychological tests, laboratory tests (including magnesium determination on serum), neuroendocrine evaluation (circadian rhythm of several hormones, buspirone challenge test), SPECT scans to evaluate cerebral perfusion, and other examinations where necessary in according to the symptomatology of each patient (e.g., orthopedic, ORL, EMG, muscle biopsy, etc.).

According to our preliminary results, we subdivided our patients in different subgroups and we studied them comparatively.

We report the more significant data collected from this evaluation that might lead to a better understanding of the syndrome and in particular of its pathways course, a knowledge that will help in choosing appropriate therapies for each subgroups.

[ Article copies available for a fee from The Haworth Document Delivery Service: 1-800-342-9678. E-mail address: getinfo@haworthpressinc.com .]

KEYWORDS. Chronic fatigue syndrome, fibromyalgia, pain, neurally mediated hypotension, SPECT, myopathies

Delia Racciatti, Annamaria Barbeno, Jacopo Vecchiet, and Eligio Pizzigallo, Professor, are affiliated with the Department of Infectious Diseases, "G. D'Annunzio" University, Chieti, Italy.

Address correspondence to: Professor Eligio Pizzigallo, Department of Infectious Diseases, "G. D'Annunzio" University, Via dei Vestini 31, 66013 Chieti Scalo (Italy) (E-mail: racciatt@unich.it ).

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Posted to Co-Cure Fri, 22 Oct 1999 10:19:57 -0400

T102C Polymorphism of the 5-HT2A-Receptor Gene in Fibromyalgia

The T102C Polymorphism of the 5-HT2A-Receptor Gene in Fibromyalgia.
Authors: Bondy B, Spaeth M, Offenbaecher M, Glatzeder K, Stratz T, Schwarz M, de Jonge S, Kruger M, Engel RR, Farber L, Pongratz DE, Ackenheil M
Psychiatric Hospital, University of Munich, Nusbaumstrase 7, Munich, D-80336, Germany
Journal: Neurobiology of Disease 1999 Oct;6(5):433-439
NLM citations: PMID: 10527809

[Notes: "serotonergic" refers to nerve cells that use serotonin as their neurotransmitter. Alleles are mutually exclusive forms of the same gene. Polymorphism is the existence of two or more alleles of a gene, where the frequency of the rarer alleles is greater than can be explained by recurrent mutation alone.]

Based on a possible involvement of serotonergic dysfunction in the pathophysiology of fibromyalgia (FM) and on preliminary reports of a possible genetically driven vulnerability for this disorder, the authors investigated the silent T102C polymorphism of the 5-HT2A-receptor gene in 168 FM patients and 115 healthy controls. They found a significantly different genotype distribution in FM patients and suggest that while theT102C polymorphism is not directly involved in the cause of FM, it may be linked to an as-yet-unspecified variant which is.

The abstract may be read at:
http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?uid=10527809&form=6&db=m&Dopt=b

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Posted to Co-Cure Fri, 22 Oct 1999 10:29:51 -0400

Borna disease virus infection in two family clusters of patients with CFS

Borna disease virus infection in two family clusters of patients with chronic fatigue syndrome.
Authors: Nakaya T, Takahashi H, Nakamur Y, Kuratsune H, Kitani T, Machii T, Yamanishi K, Ikuta K
Section of Serology, Institute of Immunological Science, Hokkaido University, Sapporo, Japan.
Journal: Microbiology and Immunology 1999;43(7):679-89
NLM citations: PMID: 10529109, UI: 99456388

Within the two families, all members with CFS were infected with BDV, with antibodies to viral p40, p24 and/or gp18 and BDV p24 RNA in peripheral blood mononuclear cells. All but one of the healthy members were negative by both assays.

The abstract may be read at: http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?uid=10529109&form=6&db=m&Dopt=b

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Posted to Co-Cure Thu, 21 Oct 1999 04:37:15 +0000 by Roger Burns of CFS-NEWS

CFS case definition to be revised by CDC

The Centers for Disease Control and Prevention (CDC) has announced on that they will convene a scientific panel to revise the case definition for chronic fatigue syndrome the year 2000. The announcement was made by the CDC's Dr. William Reeves at a meeting with CFS leaders on Oct. 13. Dr. Reeves has commented in recent years that the CFS definition will likely be revised someday to identify subgroups. At the recent meeting, Reeves said that the CDC now has enough information in hand to warrant a revision. No specific date was given as to when next year the scientific panel would be convened.

Regarding subgroups, Reeves was asked by Roger Burns (publisher of CFS-NEWS) about the key criterion that distinguishes M.E. (myalgic encephalomyelitis) from CFS. That criterion is that symptoms are exacerbated following exercise. Reeves was asked, given his broad knowledge of definitional issues regarding CFS, what are the advantages and disadvantages of creating a subgroup within CFS that requires that M.E. criterion. Reeves replied that "We are using that now", and he further said that there were many more advantages than disadvantages in accepting that criterion.

Jill McLaughlin of the National CFIDS Foundation then asked CDC officials to recognize M.E. as a separate and distinct illness. Jeffrey Koplan, Director of the CDC, said that request would be given consideration.

CDC officials will next be reporting in public about CFS issues at the upcoming meeting of the U.S. CFS Coordinating Committee on Nov. 2 in Washington, DC.

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Posted to Co-Cure Wed, 20 Oct 1999 12:22:20 -0400

Absence of Borrelia burgdorferi-specific immune complexes in chronic fatigue syndrome

Absence of Borrelia burgdorferi-specific immune complexes in chronic fatigue syndrome
Authors: Schutzer SE, Natelson BH
Department of Medicine, University of Medicine and Dentistry, New Jersey Medical School, Newark 07103, USA. schutzer@umdnj.edu
Journal: Neurology 1999 Oct 12;53(6):1340-1
NLM citations: PMID: 10522896, UI: 99450731

The authors found that both CFS patients and healthy subjects tested negative for Borrelia burgdorferi (Bb), the cause of Lyme disease, concluding that CDC-defined CFS patients who do not present with the more specific symptoms of Lyme disease, such as erythema migrans (the classic early rash), Bell's palsy, or large joint arthritis, "are not likely to have laboratory evidence of Bb infection."

The abstract may be read at:
http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?uid=10522896&form=6&db=m&Dopt=b

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Posted to Co-Cure Thu, 14 Oct 1999 17:50:23 -0400

Orthostatic intolerance and chronic fatigue syndrome associated with Ehlers-Danlos syndrome

Orthostatic intolerance and chronic fatigue syndrome associated with Ehlers-Danlos syndrome.
Authors: Rowe PC, Barron DF, Calkins H, Maumenee IH, Tong PY, Geraghty MT
Departments of Pediatrics and Medicine and the Center for Hereditary Eye Diseases, Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland.
Journal of Pediatrics 1999 Oct;135(4):494-499 (ISSN0022-3476)
NLM citation: PMID: 10518084
Reprint requests: Peter C. Rowe, MD, Brady 212, Johns Hopkins Hospital, 600 N Wolfe St, Baltimore, MD 21287. Copyright 1999 by Mosby, Inc.

The authors studied the connection between CFS, Ehlers-Danos Syndrome and orthostatic intolerance in a group of adolescent clinic patients. Because of the overlap they found, they suggest that "a careful search for hypermobility and connective tissue abnormalities should be part of the evaluation of patients with CFS and orthostatic intolerance syndromes."

The abstract can be read at:
http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?uid=10518084&form=6&db=m&Dopt=b

For information on Ehlers-Danos Syndrome, see http://www.ednf.org/ and http://www.stepstn.com/cgi-win/nord.exe?proc=GetDocument&rectype=0&recnum=240

Orthostatic intolerance, a common symptom in CFS, is the general inability to be upright for any length of time without various symptoms, including lightheadedness, dizziness, fainting, and nausea. The most well-publicized type of OI is neurally-mediated hypotension (NMH), but many people with OI do not test positive for blood pressure abnormalities.

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Posted to Co-Cure Tue, 12 Oct 1999 20:07:46 -0400

Fibromyalgia in the Journal "Arthritis Care and Research"

The following articles have appeared recently in the journal "Arthritis Care and Research", published by the Association of Rheumatology Health Professionals (http://www.rheumatology.org/arhp/).

The Fibromyalgia Impact Questionnaire: a useful tool in evaluating patients with post-Lyme disease syndrome.
Authors: Fallon J, Bujak DI, Guardino S, Weinstein A
Leinhard School of Nursing, Pace University, Pleasantville, New York, USA.
1999 Feb;12(1):42-7
NLM citations: PMID: 10513489, UI: 99442980

The abstract may be read at:
http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?uid=10513489&form=6&db=m&Dopt=b


What constitutes a fibromyalgia expert?
Author: Wallace DJ
1999 Apr;12(2):82-4
PMID: 10513495, UI: 99442986
(No other information currently available)


A randomized, controlled trial of exercise and education for individuals with fibromyalgia.
Authors: Gowans SE, deHueck A, Voss S, Richardson M
Department of Rehabilitation Services, Toronto Hospital, Ontario, Canada.
1999 Apr;12(2):120-8
NLM citations: PMID: 10513500, UI: 99442991

The abstract may be read at:
http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?uid=10513500&form=6&db=m&Dopt=b


Tests of functional limitations in fibromyalgia syndrome: a reliability study.
Mannerkorpi K, Svantesson U, Carlsson J, Ekdahl C
Department of Physical Therapy, Sahlgrenska University Hospital, Goteborg, Sweden
1999 Jun;12(3):193-9
PMID: 10513509, UI: 99443000

The abstract may be read at:
http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?uid=10513509&form=6&db=m&Dopt=b


A Comparative Evaluation of a Fibromyalgia Rehabilitation Program
Authors: Annette Bailey, Leslie Starr, Monica Alderson, and Julie Moreland
1999 Oct; 12(5) 336+
(No other information currently available)

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Contact Co-Cure support personnel through our on-line form or by sending an email message to Co-Cure-Mod@listserv.nodak.edu.

Note: All abstract summaries, unless otherwise noted, were prepared by Margaret Bailey.

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